CSII is related to more stable glycemia in adults with type 1 diabetes

Endocrine. 2022 Mar;75(3):776-780. doi: 10.1007/s12020-021-02913-9. Epub 2021 Oct 25.

Abstract

Purpose: The purpose of the present study was to compare the basic glycemic control parameters-HbA1c, CV%, and hypoglycemia, as well as quality of life and depression score in patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI).

Methods: 324 adult patients with type 1 diabetes-146 using CSII and 178 on MDI, were enrolled in this cross-sectional study. HbA1c was assessed in whole blood by immuno-turbidimetric NGSP certified method. CV% was derived from CGM or was calculated from a 9-point capillary blood glucose profile. Hypoglycemia frequency, severity, and awareness were assessed using Clarke's hypoglycemia questionnaire. Quality of life (QOL) was assessed using a questionnaire by the Psychiatric Research Unit and the CES-D scale.

Results: CSII group compared to MDI group showed significantly lower HbA1c-7.3% (6.6-8.0%) vs 8.2% (7.2-9.6%) (p < 0.0001), lower CV 27.2% (±9.8) vs 34.7% (±11.3) (p < 0.0001), fewer hypoglycemia episodes (p < 0.0001). There was no significant difference in the frequency of severe hypoglycemia, hypoglycemia awareness, QOL, and depression scores between the two groups.

Conclusions: CSII in type 1 diabetes is related to better and more stable glycemic control compared to MDI.

Keywords: Continuous subcutaneous insulin infusion; Glycemic variability; Multiple daily injections; Type 1 diabetes.

MeSH terms

  • Adult
  • Blood Glucose
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 1* / drug therapy
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Injections, Subcutaneous
  • Insulin / adverse effects
  • Insulin Infusion Systems
  • Quality of Life

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin