scholarly journals SIX MONTHS PUMP TREATMENT IMPROVES ARTERIAL STIFFNESS AND ENDOTHELIAL GLYCOCALYX VS INTENSIFICATION WITH MULTIPLE DAILY INSULIN INJECTIONS IN PATIENTS WITH TYPE 1 DIABETES INDEPENDENTLY OF GLYCEMIC CONTROL

2021 ◽  
Vol 77 (18) ◽  
pp. 1851
Author(s):  
Aikaterini Kountouri ◽  
John Thymis ◽  
Emmanouil Korakas ◽  
Konstantinos Balampanis ◽  
Loukia Pliouta ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Arterial Stiffness ◽  
Endothelial Glycocalyx ◽  
Daily Insulin ◽  
Multiple Daily Insulin Injections

scholarly journals Effects of Treatment With Continuous Subcutaneous Insulin Infusion on Arterial Stiffness and Endothelial Glycocalyx Compared to MDI Intensification in Patients With Type 1 Diabetes: Improvement After a Six-Month Pump Treatment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A458-A459
Author(s):  
Aikaterini Kountouri ◽  
John Thymis ◽  
Foteini Kousathana ◽  
Konstantinos Balampanis ◽  
Loukia Pliouta ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Arterial Stiffness ◽  
Vascular Function ◽  
Continuous Subcutaneous Insulin Infusion ◽  
Insulin Infusion ◽  
Endothelial Glycocalyx ◽  
Control Group ◽  
Subcutaneous Insulin

Abstract Patients with type 1 diabetes mellitus (T1DM) present signs of atherosclerosis and endothelial dysfunction earlier compared to healthy individuals. The evidence regarding the efficacy of continuous subcutaneous insulin infusion (CSII) in vascular function in T1DM are scarce. The aim of this study is to determine whether insulin intensification with CSII improves arterial stiffness and endothelial function in T1DM compared to multiple daily insulin (MDI) injections. Thirty patients with T1DM were included in our study. Fifteen patients with poor glycemic control were transitioned from MDI to CSII and were reviewed immediately prior (baseline) and six months after the initiation of CSII. Fifteen patients, matched for sex, age and glycemic control, remained on intensified treatment with MDI (control group). In all patients at each visit we measure a) Carotid-femoral PWV b) central systolic blood pressure (cSBP) c) perfused boundary region (PBR) of the sublingual arterial microvessels. Both groups had similar cardiovascular markers and HbA1c at baseline (p>0.05). After a six month treatment period, patients on CSII improved HbA1c (7.9±1.5% vs 7.35±0.7%, p<0.05), PBR (2.1±0.2 vs. 2±0.2 μm, p<0.05), PWV (7.5±0.3 vs. 7.4±1.1m/s, p<0,05) and cSBP (114.6±12.5 vs. 112±5.4 mmHg, p<0.05). There were no statistically significant differences in PBR (2±0.3 vs. 2±0.3 μm, p>0.05), PWV (8±2.3 vs. 8±1.9m/s, p>0.05) and cSBP (115±15.2 vs. 115.7±15.4 mmHg, p>0.05) in patients who remained on MDI, despite improvement of HbA1c (8±1.1% vs 7.36±0.8%, p<0.05). The use of CSII improves the thickness of endothelial glycocalyx and decreases arterial stiffness after six months treatment in patients with T1DM.

scholarly journals Cessation of Multiple Daily Insulin Injections in a Person with Twenty-Nine Years of “Type 1 Diabetes”

2017 ◽  
Vol 02 (01) ◽  
Author(s):  
Joel LIM Guanyi ◽  
Su Fen ANG ◽  
Clara Tan SH ◽  
Jessie Fong CW ◽  
Su Chi LIM
Keyword(s):  
Type 1 Diabetes ◽  
Daily Insulin ◽  
Multiple Daily Insulin Injections

scholarly journals The Association Between HbA1c and Time in Hypoglycemia During CGM and Self-Monitoring of Blood Glucose in People With Type 1 Diabetes and Multiple Daily Insulin Injections: A Randomized Clinical Trial (GOLD-4)

2020 ◽  
Author(s):  
Shilan Seyed Ahmadi ◽  
Klara Westman ◽  
Aldina Pivodic ◽  
Arndís F Ólafsdóttir ◽  
Sofia Dahlqvist ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Conventional Therapy ◽  
Self Monitoring ◽  
Glucose Levels ◽  
Daily Insulin ◽  
Multiple Daily Insulin Injections ◽  
Mean Glucose ◽  
Hba1c Levels

<b><i>Objective: </i></b>According to recent guidelines, individuals with type 1 diabetes should spend less than 4.0% per day with glucose levels <3.9 mmol/L (<70 mg/dL) and less than 1.0% per day <3.0 mmol/L (<54 mg/dL). <p><b><i><br> Research methods: </i></b>In the GOLD randomised cross-over trial, 161 individuals with type 1 diabetes treated with multiple daily insulin injections (MDI) were randomised to Continuous Glucose Monitoring (CGM) or conventional therapy with self-monitoring of blood glucose (SMBG) and evaluated over 16 months. We estimated the association between time spent in hypoglycaemia and various mean glucose and HbA1c levels.</p> <p> </p> <p><b><i>Results: </i></b>Time spent in hypoglycaemia (<3.9 mmol/L and <3.0 mmol/L) increased significantly with lower mean HbA1c and mean glucose levels during both CGM and conventional therapy. During CGM, 24 (57.1%) individuals with HbA1c <7.5 % (<58 mmol/mol) had <1.0% time spent in hypoglycaemia <3.0 mmol/L and 23 (54.8%) had <4.0% time spent in hypoglycaemia <3.9 mmol/L. During CGM, mean time spent in hypoglycaemia for individuals with mean HbA1c 7.0% (52 mmol/mol) was estimated to be 5.4% for <3.9 mmol/L and 1.5% for <3.0 mmol/L. The corresponding values during SMBG were 9.2% and 3.5%, respectively. Individuals with mean glucose levels of 8 mmol/L spent 4.9% more time with glucose levels <3.9 mmol/L and 2.8% more time <3.0 mmol/L during SMBG compared with CGM.</p> <p> </p> <p><b><i>Conclusions: </i></b>Reaching current targets for time in hypoglycaemia and at the same time HbA1c targets is challenging for type 1 diabetes patients treated with MDI both with CGM and SMBG monitoring. However, CGM is associated with considerably less time in hypoglycaemia than SMBG at a broad range of HbA1c levels and is crucial for patients with MDI treatment to have a chance to approach hypoglycaemia targets.</p>

Sign in / Sign up

Export Citation Format

Share Document