Use of Continuous Subcutaneous Insulin Infusion Pump in Patients With Type 2 Diabetes Mellitus

2005 ◽  
Vol 31 (6) ◽  
pp. 843-848 ◽  
Author(s):  
Susan Nielsen ◽  
Donna Kain ◽  
Elizabeth Szudzik ◽  
Sandeep Dhindsa ◽  
Rajesh Garg ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Homeostasis ◽  
Insulin Infusion ◽  
Infusion Pump ◽  
Hypoglycemic Agents ◽  
Management Problem ◽  
Oral Hypoglycemic Agents ◽  
High Doses ◽  
Hba1c Levels

Purpose In patients with type 2 diabetes, the control of hyperglycemia is often difficult despite full doses of oral hypoglycemic agents and extremely large doses of insulin. These patients pose a major management problem. The authors therefore investigated whether insulin given as a subcutaneous continuous infusion of insulin (CSII) would result in an improvement in glucose homeostasis. Methods Four patients with badly controlled type 2 diabetes, on treatment with extremely high doses of insulin and oral hypoglycemic agents, were started on CSII. Results All four patients had a marked improvement in plasma glucose concentrations with a corresponding fall in HbA1c levels. This improvement was associated with a marked fall in the insulin doses necessary to maintain adequate glucose homeostasis. Conclusions Since HbA1c levels fell from levels that would be associated with diabetic complications to those at which complications are markedly reduced, we recommend that patients with type 2 diabetes uncontrolled on extremely high doses of insulin be given a trial of treatment with CSII.

scholarly journals A Randomized Trial of Insulin Glargine plus Oral Hypoglycemic Agents versus Continuous Subcutaneous Insulin Infusion to Treat Newly Diagnosed Type 2 Diabetes

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Shuo Lin ◽  
Mu Chen ◽  
Wanling Chen ◽  
Keyi Lin ◽  
Panwei Mu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Insulin Glargine ◽  
Basal Insulin ◽  
Insulin Infusion ◽  
Cell Function ◽  
Hypoglycemic Agents ◽  
Newly Diagnosed ◽  
Oral Hypoglycemic Agents

Aims. Basal insulin plus oral hypoglycemic agents (OHAs) has not been investigated for early intensive antihyperglycemic treatment in people with newly diagnosed type 2 diabetes. This study is aimed at comparing the short-term (over a period of 12 days) effects of basal insulin glargine plus OHAs and continuous subcutaneous insulin infusion (CSII) on glycemic control and beta-cell function in this setting. Methods. An open-label parallel-group study. Newly diagnosed hospitalized patients with type 2 diabetes and fasting plasma glucose (FPG) ≥11.1 mmol/L or glycated hemoglobin (HbA1c) ≥9% (75 mmol/mol) were randomized to CSII or insulin glargine in combination with metformin and gliclazide. The primary outcome measure was the mean amplitude of glycemic excursions (MAGE), and secondary endpoints included time to reach glycemic control target (FPG < 7 mmol/L and 2-hour postprandial plasma glucose < 10 mmol/L), markers of β-cell function, and hypoglycemia. Results. Subjects in the CSII (n=35) and basal insulin plus OHA (n=33) groups had a similar significant reduction from baseline to end of treatment in glycated albumin (−6.44 ± 3.23% and− 6.42 ± 3.56%, P=0.970). Groups A and B have comparable time to glycemic control (3.6 ± 1.2 days and 4.0 ± 1.4 days), MAGE (3.40 ± 1.40 mmol/L vs. 3.16 ± 1.38 mmol/L; p=0.484), and 24-hour mean blood glucose (7.49 ± 0.96 mmol/L vs. 7.02 ± 1.03 mmol/L). Changes in the C-peptide reactivity index, the secretory unit of islet in transplantation index, and insulin secretion-sensitivity index-2 indicated a greater β-cell function improvement with basal insulin plus OHAs versus CSII. Conclusions. Short-term insulin glargine plus OHAs may be an alternative to CSII for initial intensive therapy in people with newly diagnosed type 2 diabetes.

scholarly journals Patterns of Adherence to Oral Hypoglycemic Agents and Glucose Control among Primary Care Patients with Type 2 Diabetes

2014 ◽  
Vol 42 (2) ◽  
pp. 63-71 ◽  
Author(s):  
Heather F. de Vries McClintock ◽  
Knashawn H. Morales ◽  
Dylan S. Small ◽  
Hillary R. Bogner
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Glucose Control ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents ◽  
Primary Care Patients

scholarly journals The importance and advantages of the timely prescription of insulin to the patients with type 2 diabetes mellitus

2012 ◽  
Vol 58 (3) ◽  
pp. 56-60
Author(s):  
I R Iarek-Martynova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Therapy ◽  
Clinical Situation ◽  
Hypoglycemic Agents ◽  
Negative Consequences ◽  
Oral Hypoglycemic Agents ◽  
Adequate Treatment

The onset of insulin therapy is an important stage in the treatment of type 2 diabetes mellitus. Its timely beginning ensures better control of glycemia and reduces the negative consequences of chronic glucose cytotoxicity and lipotoxicity. The achievement and maintenance of the stable compensation of the disease are the indispensable conditions for successful prophylaxis and adequate treatment of chronic complications of diabetes mellitus. The ADA guidelines recommend to initiate insulin therapy at the early stages of the disease provided it is dictated by the clinical situation or combine it with the use of oral hypoglycemic agents if the targeted HbA1c levels fail to be reached despite the intake of one or more tableted preparations.

scholarly journals Combination Therapy of Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus

2017 ◽  
Vol 41 (5) ◽  
pp. 357 ◽  
Author(s):  
Min Kyong Moon ◽  
Kyu-Yeon Hur ◽  
Seung-Hyun Ko ◽  
Seok-O Park ◽  
Byung-Wan Lee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Combination Therapy ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents
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