Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care
Abstract Aims The aim of this study was to compare individuals with type 1 diabetes with continuous subcutaneous insulin infusion (CSII) and intensified insulin therapy (ICT) in routine care regarding metabolic control and treatment satisfaction. Methods Individuals with type 1 diabetes (CSII n = 74...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-07-01
|
| Series: | Diabetology & Metabolic Syndrome |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13098-021-00700-0 |
| _version_ | 1819091798032646144 |
|---|---|
| author | Guido Kramer Christof Kloos Ulrich A. Müller Gunter Wolf Nadine Kuniss |
| author_facet | Guido Kramer Christof Kloos Ulrich A. Müller Gunter Wolf Nadine Kuniss |
| author_sort | Guido Kramer |
| collection | DOAJ |
| description | Abstract Aims The aim of this study was to compare individuals with type 1 diabetes with continuous subcutaneous insulin infusion (CSII) and intensified insulin therapy (ICT) in routine care regarding metabolic control and treatment satisfaction. Methods Individuals with type 1 diabetes (CSII n = 74; ICT n = 163) were analysed regarding metabolic control, frequency of hypoglycaemia and treatment satisfaction (DTSQs range 0–36). Results Individuals with CSII (duration of CSII: 14.1 ± 7.2 years) were younger (51.1 ± 15.8 vs. 56.2 ± 16.2 years, p = 0.023), had longer diabetes duration (28.7 ± 12.4 vs. 24.6 ± 14.3 years, p = 0.033), lower insulin dosage (0.6 ± 0.2 vs. 0.7 ± 0.4 IU/kg, p = 0.004), used more frequently short-acting analogue insulin (90.5% vs. 48.5%, p < 0.001) and flash/continuous glucose monitoring (50.0% vs. 31.9%, p = 0.009) than people with ICT. HbA1c was similar between CSII and ICT (7.1 ± 0.8%/54.4 ± 9.1 mmol/mol vs. 7.2 ± 1.0%/55.7 ± 10.9 mmol/mol, p = 0.353). Individuals with CSII had higher frequency of non-severe hypoglycaemia per week (in people with blood glucose monitoring: 1.9 ± 1.7 vs. 1.2 ± 1.6, p = 0.014; in people with flash/continuous glucose monitoring: 3.3 ± 2.2 vs. 2.1 ± 2.0, p = 0.006). Prevalence of polyneuropathy (18.9% vs. 38.0%, p = 0.004) and systolic blood pressure (138.0 ± 16.4 vs. 143.9 ± 17.1 mmHg, p = 0.014) was lower in CSII. Satisfaction with diabetes treatment (26.7 ± 7.3 vs. 26.0 ± 6.8, p = 0.600) did not differ between CSII and ICT. Conclusions CSII and ICT yielded comparable metabolic control and treatment satisfaction but CSII was associated with higher incidence of non-severe hypoglycaemia and lower insulin dosage. |
| first_indexed | 2024-12-21T22:45:26Z |
| format | Article |
| id | doaj.art-8d2bf791b8444776ba60c1299f33b308 |
| institution | Directory Open Access Journal |
| issn | 1758-5996 |
| language | English |
| last_indexed | 2024-12-21T22:45:26Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj.art-8d2bf791b8444776ba60c1299f33b3082022-12-21T18:47:43ZengBMCDiabetology & Metabolic Syndrome1758-59962021-07-011311710.1186/s13098-021-00700-0Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine careGuido Kramer0Christof Kloos1Ulrich A. Müller2Gunter Wolf3Nadine Kuniss4Department of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University HospitalDepartment of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University HospitalOutpatient healthcare centre Dr. med. KielsteinDepartment of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University HospitalDepartment of Internal Medicine III, Endocrinology and Metabolic Disorders, Jena University HospitalAbstract Aims The aim of this study was to compare individuals with type 1 diabetes with continuous subcutaneous insulin infusion (CSII) and intensified insulin therapy (ICT) in routine care regarding metabolic control and treatment satisfaction. Methods Individuals with type 1 diabetes (CSII n = 74; ICT n = 163) were analysed regarding metabolic control, frequency of hypoglycaemia and treatment satisfaction (DTSQs range 0–36). Results Individuals with CSII (duration of CSII: 14.1 ± 7.2 years) were younger (51.1 ± 15.8 vs. 56.2 ± 16.2 years, p = 0.023), had longer diabetes duration (28.7 ± 12.4 vs. 24.6 ± 14.3 years, p = 0.033), lower insulin dosage (0.6 ± 0.2 vs. 0.7 ± 0.4 IU/kg, p = 0.004), used more frequently short-acting analogue insulin (90.5% vs. 48.5%, p < 0.001) and flash/continuous glucose monitoring (50.0% vs. 31.9%, p = 0.009) than people with ICT. HbA1c was similar between CSII and ICT (7.1 ± 0.8%/54.4 ± 9.1 mmol/mol vs. 7.2 ± 1.0%/55.7 ± 10.9 mmol/mol, p = 0.353). Individuals with CSII had higher frequency of non-severe hypoglycaemia per week (in people with blood glucose monitoring: 1.9 ± 1.7 vs. 1.2 ± 1.6, p = 0.014; in people with flash/continuous glucose monitoring: 3.3 ± 2.2 vs. 2.1 ± 2.0, p = 0.006). Prevalence of polyneuropathy (18.9% vs. 38.0%, p = 0.004) and systolic blood pressure (138.0 ± 16.4 vs. 143.9 ± 17.1 mmHg, p = 0.014) was lower in CSII. Satisfaction with diabetes treatment (26.7 ± 7.3 vs. 26.0 ± 6.8, p = 0.600) did not differ between CSII and ICT. Conclusions CSII and ICT yielded comparable metabolic control and treatment satisfaction but CSII was associated with higher incidence of non-severe hypoglycaemia and lower insulin dosage.https://doi.org/10.1186/s13098-021-00700-0Type 1 diabetesIntensified insulin therapyInsulin pump therapyContinuous subcutaneous insulin infusion |
| spellingShingle | Guido Kramer Christof Kloos Ulrich A. Müller Gunter Wolf Nadine Kuniss Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care Diabetology & Metabolic Syndrome Type 1 diabetes Intensified insulin therapy Insulin pump therapy Continuous subcutaneous insulin infusion |
| title | Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care |
| title_full | Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care |
| title_fullStr | Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care |
| title_full_unstemmed | Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care |
| title_short | Metabolic control and hypoglycaemia in people with type 1 diabetes: insulin pump therapy vs. intensified insulin therapy in an unselected cohort in routine care |
| title_sort | metabolic control and hypoglycaemia in people with type 1 diabetes insulin pump therapy vs intensified insulin therapy in an unselected cohort in routine care |
| topic | Type 1 diabetes Intensified insulin therapy Insulin pump therapy Continuous subcutaneous insulin infusion |
| url | https://doi.org/10.1186/s13098-021-00700-0 |
| work_keys_str_mv | AT guidokramer metaboliccontrolandhypoglycaemiainpeoplewithtype1diabetesinsulinpumptherapyvsintensifiedinsulintherapyinanunselectedcohortinroutinecare AT christofkloos metaboliccontrolandhypoglycaemiainpeoplewithtype1diabetesinsulinpumptherapyvsintensifiedinsulintherapyinanunselectedcohortinroutinecare AT ulrichamuller metaboliccontrolandhypoglycaemiainpeoplewithtype1diabetesinsulinpumptherapyvsintensifiedinsulintherapyinanunselectedcohortinroutinecare AT gunterwolf metaboliccontrolandhypoglycaemiainpeoplewithtype1diabetesinsulinpumptherapyvsintensifiedinsulintherapyinanunselectedcohortinroutinecare AT nadinekuniss metaboliccontrolandhypoglycaemiainpeoplewithtype1diabetesinsulinpumptherapyvsintensifiedinsulintherapyinanunselectedcohortinroutinecare |