Continuous Subcutaneous Insulin Infusion Initiation Is Associated With Blood Pressure Reduction in Adults With Type 1 Diabetes

Background: In type 1 diabetes (T1D) continuous subcutaneous insulin infusion (CSII) use has been associated with lower risks for mortality and diabetes-related complications when compared to multiple daily injections. There are limited data on the effect of CSII on blood pressure (BP). We aimed to evaluate the relationship between CSII initiation and BP changes. Methods: We performed a retrospective, single-center, observational study including all adults with T1D who initiated CSII between 2001 and 2014. Mean systolic BP levels were calculated from values obtained up to 15 months before and up 15 months after CSII initiation. Results: We studied 436 adults (46% male; mean [95% CI] age: 45 [36, 54] years, duration of diabetes: 20.3 [19.1, 21.5] years). CSII was associated with the following changes (post minus pre CSII levels) in mean (95% CI) SBP and DBP levels, respectively: whole cohort (N = 436): −2 (−1, −3), P < .001 and −2 (−1, −2), P < .001; those taking stable antihypertensive medication (n = 118): −4 (−6, −2), P < .001 and −2 (−3, −1), P < .001; antihypertensive treatment-naïve patients (n = 279): −1 (−2, 0), P = .147 and −1 (−2, 0), P = .002. In multivariate regression analysis including age, sex, diabetes duration, pre-CSII BP, HbA1c and weight changes, only pre-CSII BP showed an independent association with BP drop in all patients’ groups. Once adjusted for pre-CSII BP there was no significant difference between those on antihypertensive drugs and antihypertensive treatment-naïve individuals. Conclusions: We showed BP reduction in association with CSII therapy particularly in those on antihypertensive medication. These original findings may partly explain the cardiovascular and mortality benefits associated with CSII therapy.

Download Full-text

1073-P: A Study of Flat and Circadian Insulin infusion Rates in Continuous Subcutaneous Insulin Infusion (CSII) in Adults with Type 1 Diabetes (FIRST1D)

Diabetes ◽

10.2337/db19-1073-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 1073-P

Author(s):

SIAN K. RILSTONE ◽

MONIKA REDDY ◽

NICK OLIVER

Keyword(s):

Type 1 Diabetes ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Subcutaneous Insulin

Download Full-text

Indications and efficacy of continuous subcutaneous insulin infusion (CSII) therapy in Type 1 diabetes mellitus: a clinical audit in a specialist service

Diabetic Medicine ◽

10.1111/j.1464-5491.2005.01539.x ◽

2005 ◽

Vol 22 (7) ◽

pp. 842-849 ◽

Cited By ~ 30

Author(s):

I. A. S. Rodrigues ◽

H. A. Reid ◽

K. Ismail ◽

S. A. Amiel

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Clinical Audit ◽

Subcutaneous Insulin ◽

Specialist Service

Download Full-text

Long-term effects of continuous subcutaneous insulin infusion in adults with type 1 diabetes mellitus patients: Results of a public healthcare system

Endocrinología Diabetes y Nutrición (English ed ) ◽

10.1016/j.endien.2021.03.002 ◽

2021 ◽

Vol 68 (2) ◽

pp. 116-122

Author(s):

Jesus Moreno-Fernandez ◽

Luz María López ◽

Francisco Javier Gomez ◽

Pedro Pinés ◽

Benito Blanco ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Public Healthcare ◽

Subcutaneous Insulin ◽

Long Term Effects

Download Full-text

A case of local delayed-type allergy to zinc-containing insulin as a cause of diabetic ketoacidosis in a patient with type 1 diabetes mellitus undergoing continuous subcutaneous insulin infusion

Diabetology International ◽

10.1007/s13340-016-0264-0 ◽

2016 ◽

Vol 7 (4) ◽

pp. 447-450 ◽

Cited By ~ 1

Author(s):

Ken-ichi Nemoto ◽

Satoshi Ugi ◽

Seiichiro Ogaku ◽

Nobuhiko Nakaizumi ◽

Takeshi Kato ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Diabetic Ketoacidosis ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Subcutaneous Insulin

Download Full-text

Comparing Continuous Subcutaneous Insulin Infusion and Multiple Daily Injections in children with type 1 diabetes in Sweden from 2011 to 2016 – a longitudinal study from the Swedish National Quality Register ( SWEDIABKIDS )

Pediatric Diabetes ◽

10.1111/pedi.13217 ◽

2021 ◽

Author(s):

Anna‐Lena Fureman ◽

Mikael Lilja ◽

Torbjorn Lind ◽

Stefan Särnblad ◽

Marie Bladh ◽

...

Keyword(s):

Type 1 Diabetes ◽

Longitudinal Study ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Subcutaneous Insulin ◽

Multiple Daily Injections ◽

Quality Register ◽

National Quality ◽

National Quality Register

Download Full-text

Continuous subcutaneous insulin infusion alters microRNA expression and glycaemic variability in children with type 1 diabetes

Scientific Reports ◽

10.1038/s41598-021-95824-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Emma S. Scott ◽

Andrzej S. Januszewski ◽

Luke M. Carroll ◽

Gregory R. Fulcher ◽

Mugdha V. Joglekar ◽

...

Keyword(s):

Type 1 Diabetes ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Diabetes Diagnosis ◽

Subcutaneous Insulin ◽

Glycaemic Variability ◽

Altered Expression ◽

C Peptide

AbstractTo determine whether continuous subcutaneous insulin infusion (CSII) vs. multiple daily injections (MDI) therapy from near-diagnosis of type 1 diabetes is associated with reduced glycaemic variability (GV) and altered microRNA (miRNAs) expression. Adolescents (74% male) within 3-months of diabetes diagnosis (n = 27) were randomized to CSII (n = 12) or MDI. HbA1c, 1-5-Anhydroglucitol (1,5-AG), high sensitivity C-peptide and a custom TaqMan qPCR panel of 52 miRNAs were measured at baseline and follow-up (median (LQ-UQ); 535 (519–563) days). There were no significant differences between groups in baseline or follow-up HbA1c or C-peptide, nor baseline miRNAs. Mean ± SD 1,5-AG improved with CSII vs. MDI (3.1 ± 4.1 vs. − 2.2 ± − 7.0 mg/ml respectively, P = 0.029). On follow-up 11 miRNAs associated with diabetes vascular complications had altered expression in CSII-users. Early CSII vs. MDI use is associated with lower GV and less adverse vascular-related miRNAs. Relationships with future complications are of interest.

Download Full-text

Effectiveness of Multiple Daily Injections or Continuous Subcutaneous Insulin Infusion for Children with Type 1 Diabetes Mellitus in Clinical Practice

International Journal of Endocrinology ◽

10.1155/2014/526591 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Chun-xiu Gong ◽

Li-ya Wei ◽

Di Wu ◽

Bing-yan Cao ◽

Xi Meng ◽

...

Keyword(s):

Type 1 Diabetes ◽

Glucose Control ◽

Continuous Subcutaneous Insulin Infusion ◽

Insulin Infusion ◽

Blood Glucose Control ◽

Insulin Dosage ◽

Subcutaneous Insulin ◽

Multiple Daily Injections ◽

Hba1c Levels

Aims. To determine whether multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) contributes to better glucose control in children with different type 1 diabetes duration.Methods. Subjects were grouped according to early (≤1 year after disease onset; 1A) or late (1–3 years after onset; 2A) MDIs/CSII treatment initiation. Corresponding control groups (1B, 2B) received insulin injections twice daily.Results. HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; allP<0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%;P=0.04). Levels were lower in group 1A than in group 2A when disease duration was matched (7.61% versus 8.49%;P<0.05). Logistic regression revealed no correlation between HbA1c level and MDIs/CSII therapy. HbA1c levels were only negatively related to insulin dosage.Conclusions. Blood glucose control was better in patients receiving MDIs/CSII than in those receiving conventional treatment. Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation. MDIs/CSII therapy should be combined with comprehensive management.

Download Full-text