A Systematic Review and Meta-Analysis of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Injections in Type-2 Diabetes

Medicina (Kaunas). 2023 Jan 10;59(1):141. doi: 10.3390/medicina59010141.

Abstract

Diabetes mellitus (DM) has a growing prevalence worldwide, even in developing countries. Many antidiabetic agents are used to improve glycemic control; however, in cases of an insufficient outcome, insulin is administered. Yet, the timing of proper insulin administration is still a subject of intense research. To date, there have been no recommendations or guidelines for the use of continuous subcutaneous insulin infusion (CSII) in Type 2 Diabetes Mellitus (T2DM). In the present study, we have performed a meta-analysis to evaluate the use of CSII in patients with T2DM. An extensive literature search was conducted through the electronic databases Pubmed, Clinicaltrials.gov, and Cochrane Central Register of Controlled Trials (CENTRAL) from October 2019-May 2022, for interventional studies related to T2DMI and CSII versus multiple daily injections (MDI). We included articles published in the English language only, yielding a total of thirteen studies. We found better outcomes in patients receiving CSII, in regard to glycated hemoglobin (HbA1c) and total insulin dose. In contrast, fasting plasma glucose and body weight did not show statistically significant differences between the two groups. Our analyses showed that CSII could be beneficial in patients with T2DM in order to achieve their glucose targets.

Keywords: continuous subcutaneous insulin infusion; fasting plasma glucose; glycated hemoglobin; insulin daily injection; type 2 diabetes mellitus.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Blood Glucose
  • Diabetes Mellitus, Type 1*
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Injections, Subcutaneous
  • Insulin / therapeutic use
  • Insulin Infusion Systems

Substances

  • Insulin
  • Hypoglycemic Agents
  • Blood Glucose

Grants and funding

This research received no external funding.