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Continuous subcutaneous insulin infusion leads to immediate, stable and long‐term changes in metabolic control
Author(s) -
Aberle I.,
Zimprich D.,
BachKliegel B.,
Fischer C.,
Gorny M.,
Kliegel A.,
Langer K.,
Kliegel M.
Publication year - 2008
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/j.1463-1326.2007.00707.x
Subject(s) - metabolic control analysis , medicine , diabetes mellitus , insulin , glycosylated haemoglobin , analysis of variance , insulin pump , type 1 diabetes , pediatrics , endocrinology , type 2 diabetes
Background: Evaluations of continuous subcutaneous insulin infusion (CSII) usually focus on one pre‐ and one post‐CSII measurement to assess metabolic therapy outcome. Aim: Extending this research, the aim of the present study was to provide a more fine‐grained analysis of achieved glycaemic control. Methods: In 52 patients with type 1 diabetes (mean age of 37.85 years at CSII begin; s.d. ± 12.41), haemoglobin A 1c (HbA 1c ) levels were assessed every 3 months over a period of 5 years (1 year before and 4 years after the introduction of CSII). Mixed models were utilized to describe changes in glycaemic control. Results: The pre–post course showed that already in the first quarter, a statistically significant lower HbA 1c level was obtained [7.30%, in contrast to 8.21% at the last quarter with intensified conventional therapy (ICT)]. In the following 15 quarters, the mean HbA 1c levels remained constantly lower than that with ICT. Overall, the aggregated mean HbA 1c level of patients with CSII therapy was 7.19%, in contrast to 8.08% with ICT; thus, an overall decrease by 11% was achieved. In addition, individual differences in blood glucose level and age of diabetes onset as a predictor for therapy success were analysed. Conclusions: The data show an immediate, stable and long‐term effect of CSII on HbA 1c . In addition, a significant relationship between metabolic control and age of diabetes onset was found, as well as a reduction of variance in HbA 1c levels between subjects after change to CSII.