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Diabetes Obes Metab. 2008 Apr;10(4):329-35. doi: 10.1111/j.1463-1326.2007.00707.x.

Continuous subcutaneous insulin infusion leads to immediate, stable and long-term changes in metabolic control.

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1
Department of Psychology, University of Zurich, Zurich, Switzerland.

Abstract

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.

[Indexed for MEDLINE]

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