Cited by 373Diabetes Management and ResearchDiabetes and associated disordersDiabetes Management and Education

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A Randomized, Prospective Trial Comparing the Efficacy of Continuous Subcutaneous Insulin Infusion With Multiple Daily Injections Using Insulin Glargine

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Doyle (Boland), Elizabeth A., Weinzimer, Stuart A., Steffen, Amy T., Ahern, Jo Ann H., Vincent, Miranda, Tamborlane, William V.·2004·Diabetes Care

DOI 10.2337/diacare.27.7.1554

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Abstract

OBJECTIVE—The efficacy of the insulin analogs now available for multiple daily injection (MDI) and continuous subcutaneous insulin infusion (CSII) therapy in type 1 diabetes has not yet been established in pediatric patients. Our principal aim in this short-term study was to compare the efficacy of CSII to MDI with glargine in lowering HbA1c levels in children and adolescents with type 1 diabetes. RESEARCH DESIGN AND METHODS—Thirty-two youth with type 1 diabetes (age 8–21 years) were randomly assigned to receive either MDI treatment with once-daily glargine and premeal/snack insulin aspart or CSII with insulin aspart. Dose titration in both groups was based on home self-monitored blood glucose measurements and monthly HbA1c. HbA1c, total daily insulin dose (TDD), self-monitored blood glucose readings, and adverse events were compared after 16 weeks of therapy. RESULTS—While there was no significant change in the glargine group (HbA1c 8.2% at baseline vs. 8.1% at 16 weeks), youth randomized to CSII had a sharp reduction in HbA1c levels, from 8.1 to 7.2% after 16 weeks of therapy (P < 0.02 vs. baseline and <0.05 vs. glargine group). TDD was unchanged in the glargine group, but significantly dropped with CSII (1.4 units/kg at baseline vs. 0.9 units/kg at 16 weeks, P < 0.01). Both groups had similar basal doses and insulin-to-carbohydrate ratios. Fasting self-monitored blood glucose was similar in both groups, but lunch, dinner, and bedtime readings were significantly lower in the CSII group (P < 0.01). CONCLUSIONS—Lower HbA1c and premeal glucose levels were more achievable in this short-term study with CSII than with glargine-based MDI treatment. CSII is an efficacious treatment to improve metabolic control in youth with type 1 diabetes.

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Achieving effective glycaemic control using an insulin micro-pump
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“In order to evaluate its effectiveness in terms of ameliorating blood glucose variability (BGV) and improving HbA1c.”
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Authors: Doyle (Boland), E. A., Weinzimer, S. A., Steffen, A. T., Ahern, J. A. H., Vincent, M., & Tamborlane, W. V.
Affiliations: From the Department of Pediatrics and the Children’s Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut
Yale University (US)
ORCID: Weinzimer, Stuart A.
Tamborlane, William V.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2004-07-01
Volume: 27
Issue: 7
Pages: 1554-1558
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.27.7.1554
OpenAlex: W2138976255
Cited by: 373
References: 15
Citations by year: 2026: 3 · 2025: 2 · 2024: 6 · 2023: 2 · 2022: 9 · 2021: 8 · 2020: 10 · 2019: 13 · 2018: 14 · 2017: 9 · 2016: 15 · 2015: 19 · 2014: 24 · 2013: 20 · 2012: 23
FWCI: 17.43
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Funders: Yale University
Novo Nordisk
National Institutes of Health (5u01hd037251-05)
National Center for Research Resources (RR06022)
Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD 37251)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: type 1 diabetes, insulin pump therapy, multiple daily insulin injections, insulin glargine, insulin aspart, glycemic control, HbA1c, total daily insulin dose, self-monitoring of blood glucose, pediatric diabetes, adolescents
MeSH terms: Insulin Glargine, Adolescent, Adult, Child, Diabetes Mellitus, Type 1, Drug Administration Schedule, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Insulin Infusion Systems, Blood Glucose Self-Monitoring, Patient Selection, Postprandial Period, Insulin, Long-Acting

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A Randomized, Prospective Trial Comparing the Efficacy of Continuous Subcutaneous Insulin Infusion With Multiple Daily Injections Using Insulin Glargine

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