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Reduction in Severe Hypoglycemia With Long-Term Continuous Subcutaneous Insulin Infusion in Type I Diabetes
Abstract
Objective To compare the incidence of severe hypoglycemia in patients crossed over from multiple daily injections (MDIs) of insulin to continuous subcutaneous insulin infusion (CSII). Research design and methods From a population of 225 patients using CSII, all patients who met the following selection criteria were included in the present study: 1) a minimum of 12 months on intensive therapy with MDIs before switching to CSII, and 2) a minimum of 12 months on CSII after crossover. Glycemic control and adverse event rates for the 1-year MDI control period were compared with those for the CSII therapy period. Results The incidence of severe hypoglycemia during MDI therapy declined from 138 to 22 events per 100 patient-years during the 1st year of CSII (P or = 8.0%, the change to CSII was associated with a significant reduction in HbA1c from baseline to year 1 (8.9 +/- 0.8 vs. 8.1 +/- 1.0%, P = 0.0004). The difference in diabetic ketoacidosis rates between the MDI year (14.6 events per 100 patient-years) and the CSII period (7.2 events per 100 patient-years) was not statistically significant. Conclusions CSII therapy was associated with a marked and sustained reduction in the rate of severe hypoglycemia without adversely affecting the level of glycemic control attained during MDI therapy. The more reproducible and flexible insulin delivery afforded by CSII was considered to be the major factor contributing to the improvement in severe hypoglycemia rates.
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“Potential advantages of insulin pump therapy compared with MDI include improved glycemic control, reduced rate of severe hypoglycemia, greater flexibility, and higher quality of life.2–6”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [2]
In the citing paper
“insulin pump therapy may improve glycemic control”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [2]
In the citing paper
“is associated with greater quality of life.2–6”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [2]
In the citing paper
“reduces the rate of severe hypoglycemia”
From Impact of government-funded insulin pump programs on insulin pump use in Canada: a cross-sectional study using the National Diabetes Repository (2021) · cites this paper as [2]
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Management of diabetes and hyperglycemia in hospitals.
Clement, S., Braithwaite, S. S., Magee, M. F., Ahmann, A., Smith, E. P., Schafer, R. G., Hirsch, I. B., & on behalf of the Diabetes in Hospitals Writing Committee (2004) · Diabetes Care · doi:10.2337/diacare.27.2.553 · Cited by 1,266
Pickup, J. C., & Sutton, A. J. (2008) · Diabetic Medicine · doi:10.1111/j.1464-5491.2008.02486.x · Cited by 630
Weissberg-Benchell, J. A., Antisdel, J. E., & SESHADRI, R. M. (2003) · Diabetes Care · doi:10.2337/diacare.26.4.1079 · Cited by 549
Franklin, V. L., Waller, A., Pagliari, C., & Greene, S. A. (2006) · Diabetic Medicine · doi:10.1111/j.1464-5491.2006.01989.x · Cited by 543
Pickup, J. C., Mattock, M., & Kerry, S. (2002) · BMJ · doi:10.1136/bmj.324.7339.705 · Cited by 481
Metadata
- Authors
- Bode, B. W., Steed, R. D., & Davidson, P. C.
- Affiliations
- Atlanta Diabetes Associates (US)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1996-04-01
- Volume
- 19
- Issue
- 4
- Pages
- 324-327
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W1989943003
- Cited by
- 257
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 7 · 2019: 2 · 2018: 6 · 2017: 7 · 2016: 5 · 2015: 5 · 2014: 8 · 2013: 6 · 2012: 9
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- severe hypoglycemia, insulin pump therapy, type 1 diabetes, multiple daily insulin injections, insulin delivery, glycemic control, HbA1c, diabetic ketoacidosis, intensive insulin therapy
- MeSH terms
- Adult, Algorithms, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hypoglycemia, Insulin, Insulin Infusion Systems, Male, Time Factors, Blood Glucose Self-Monitoring, Incidence, Diabetic Ketoacidosis, Patient Selection, Cross-Over Studies
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