scholarly journals Carbohydrate Requirements for Prolonged, Fasted Exercise With and Without Basal Rate Reductions in Adults With Type 1 Diabetes on Continuous Subcutaneous Insulin Infusion

Diabetes Care ◽  
2020 ◽  
pp. dc201554
Author(s):  
Sarah M. McGaugh ◽  
Dessi P. Zaharieva ◽  
Rubin Pooni ◽  
Ninoschka C. D’Souza ◽  
Todd Vienneau ◽  
...  
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


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Emma S. Scott ◽  
Andrzej S. Januszewski ◽  
Luke M. Carroll ◽  
Gregory R. Fulcher ◽  
Mugdha V. Joglekar ◽  
...  

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.


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.


2009 ◽  
Vol 85 (2) ◽  
pp. 153-158 ◽  
Author(s):  
Mariola Minkina-Pedras ◽  
Przemyslawa Jarosz-Chobot ◽  
Joanna Polanska ◽  
Maria Aleksandra Kalina ◽  
Adrian Marcinkowski ◽  
...  

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