scholarly journals Improved Open-Loop Glucose Control With Basal Insulin Reduction 90 Minutes Before Aerobic Exercise in Patients With Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion

Diabetes Care ◽  
2019 ◽  
Vol 42 (5) ◽  
pp. 824-831 ◽  
Author(s):  
Dessi P. Zaharieva ◽  
Sarah McGaugh ◽  
Rubin Pooni ◽  
Todd Vienneau ◽  
Trang Ly ◽  
...  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Chun-xiu Gong ◽  
Li-ya Wei ◽  
Di Wu ◽  
Bing-yan Cao ◽  
Xi Meng ◽  
...  

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Chia-Hung Lin ◽  
Feng-Ju Hsieh ◽  
Yang-Hau Van ◽  
Fu-Sung Lo

Introduction. The basal dose of insulin, proportion of total daily insulin, and circadian variation during continuous subcutaneous insulin infusion (CSII) therapy among children with type 1 diabetes mellitus (T1D) have not been fully elucidated.Materials and Methods. A total of 45 childhood patients with T1D receiving CSII therapy at Pediatrics Department of Chang Gung Memorial Hospital between 2004 and 2012 were analyzed. Patients were classified according to Tanner stage.Results. HbA1c was significantly reduced in all Tanner groups within three months of CSII therapy (from 67 mmol/mol (8.3%) to 54 mmol/mol (7.1%),P<0.05). The actual basal proportion of total daily insulin use was 34–40%. The circadian distribution of basal insulin differed markedly between the five Tanner groups. Basal insulin requirement was highest between 3:00 and 7:00 h in Tanner stages 1-2. In stages 3-4, a lower nocturnal basal insulin that increased gradually until daytime was noted. Adolescents (stage 5) displayed a high insulin peak between 6:00 and 11:00 h, and a smaller peak between 19:00 and 23:00 h.Conclusions. A smaller proportion of basal insulin to total daily insulin use, as well as varied circadian patterns of insulin use, characterized these children with T1D.


2009 ◽  
Vol 98 (3) ◽  
pp. 523-526 ◽  
Author(s):  
Agnieszka Szypowska ◽  
Maria Lipka ◽  
Marlena Błazik ◽  
Dorota Golicka ◽  
Lidia Groele ◽  
...  

2018 ◽  
Author(s):  
Goran Petrovski ◽  
Marija Zivkovic

BACKGROUND Continuous subcutaneous insulin infusion (CSII) is established model for mimicking physiological insulin, which can overcome some of these barriers. CSII therapy is becoming more popular treatment modality in young people with T1D.Several studies have demonstrated the superiority of CSII over MDI therapy in T1D patients in terms of improved glucose control, the rate of hypoglycemia, dawn phenomenon and glucose variability OBJECTIVE To describe Continuous Subcutaneous Insulin Infusion (CSII) characteristics in young people with Type 1 Diabetes (T1D) with optimal glucose control and to describe possible simple CSII settings for fine tuning. METHODS This retrospective study was conducted at University Clinic of Endocrinology, Diabetes and Metabolic Disorders in Skopje. The study enrolled CSII patients with T1D (age 12-25 years) visited our center from January to December 2016. Patient characteristics were collected through the electronic medical record system and CSII characteristics were obtained from 8 weeks reports prior to Hba1c, generated by Carelink Therapy Management Software (Medtronic, Northridge, USA). RESULTS Ninety-three patients were grouped according age: 12-18 years and 19-25 years. More than 70% of patients achieved HbA1c <7.5% (<58 mmol/mol). Significant difference in basal insulin was found between two age groups. Patients aged 12-18 years had five basal segments, less basal rate in early morning (03-07h) and slight decrease of afternoon basal rate (13-19h), comparing with patients aged 19-25 years with four basal segments, more basal rate in early morning (03-07h) and no decrease of afternoon basal rate (13-19h). CONCLUSIONS Optimal glucose control is achievable in real life conditions among T1D patients on CSII therapy. Bolus wizard, frequent bolusing, multiple basal segments, and close follow up can be determinants for better control. Simple CSII settings as a tool, derived from our data may help clinicians to fine tune T1D patients and achieve optimal glucose control. CLINICALTRIAL EN16-12


Sign in / Sign up

Export Citation Format

Share Document