Glyco-metabolic control, inflammation markers, and cardiovascular outcomes in type 1 and type 2 diabetic patients on insulin pump or multiple daily injection (italico study).

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  • Additional Information
    • Source:
      Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100883450 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1520-7560 (Electronic) Linking ISSN: 15207552 NLM ISO Abbreviation: Diabetes Metab Res Rev Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford, England : Wiley-Blackwell, c1999-
    • Subject Terms:
      Cardiovascular Diseases/*prevention & control ; Diabetes Mellitus, Type 1/*drug therapy ; Diabetes Mellitus, Type 2/*drug therapy ; Glucose Intolerance/*prevention & control ; Hypoglycemic Agents/*administration & dosage ; Inflammation/*prevention & control ; Metabolic Syndrome/*prevention & control; Adult ; Biomarkers/analysis ; Blood Glucose/analysis ; Cardiovascular Diseases/epidemiology ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/pathology ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/pathology ; Female ; Follow-Up Studies ; Glucose Intolerance/epidemiology ; Glycated Hemoglobin/analysis ; Humans ; Incidence ; Inflammation/epidemiology ; Injections, Subcutaneous/methods ; Insulin Infusion Systems/statistics & numerical data ; Italy/epidemiology ; Male ; Metabolic Syndrome/epidemiology ; Middle Aged ; Prognosis ; Retrospective Studies
    • Abstract:
      Background: To evaluate if the positive effects recorded on glycaemic control with continuous subcutaneous insulin infusion (CSII) were maintained on the long-term compared with multiple daily injection (MDI). The secondary objective was to evaluate if there is a reduction of type and number of cardiovascular events (CV).
      Methods: This retrospective, observational study evaluated glycaemic control and the number of CV in 104 patients with type 1 or 2 diabetes previously treated with MDI and initiating CSII therapy with tubed insulin pumps compared with 109 patients previously treated with MDI continuing MDI.
      Results: After 8 years, the glycaemic control including glycated haemoglobin (HbA 1c ), fasting plasma glucose (FPG), and prandial plasma glucose (PPG) improved with both CSII and MDI compared with baseline; however, HbA 1c , FPG, and PPG recorded with CSII were lower than data recorded with MDI. During the 8 years, there were fewer CV events with CSII, compared with MDI, and in particular, there were fewer cases of atrial fibrillation, premature ventricular contractions, acute coronary infarction, angina pectoris, heart failure, and peripheral vascular ischemia. We did not record any reduction of ischemic stroke events.
      Conclusion: Our preliminary data suggest that CSII treatment seems to reduce the rates of CV compared with MDI therapy. Moreover, CSII also improved glycaemic control, without increasing the number of hypoglycaemia. However, given the observational design of this trial, our data should be validated in a randomized clinical trial; if they will be confirmed, CSII could be chosen for fully informed and motivated patients at higher risk of developing CV.
      (© 2019 John Wiley & Sons, Ltd.)
    • References:
      Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-986.
      ACCORD Study Group, Gerstein HC, Miller ME, et al. Long-term effects of intensive glucose lowering on cardiovascular outcomes. N Engl J Med. 2011;364(9):818-828.
      Giménez M, López JJ, Castell C, Conget I. Hypoglycaemia and cardiovascular disease in type 1 diabetes. Results from the Catalan National Public Health registry on insulin pump therapy. Diabetes Res Clin Pract. 2012;96(2):e23-e25.
      Maffioli P, Derosa G. Hypoglycemia, its implications in clinical practice, and possible ways to prevent it. Curr Med Res Opin. 2014;30(5):771-773.
      Derosa G, Maffioli P, D'Angelo A, et al. Effects of insulin therapy with continuous subcutaneous insulin infusion (CSII) in diabetic patients: comparison with multi-daily insulin injections therapy (MDI). Endocr J. 2009;56(4):571-578.
      Metzger M, Castañeda J, Reznik Y, et al. Factors associated with improved glycemic control following continuous subcutaneous insulin infusion therapy in patients with type 2 diabetes uncontrolled with bolus-basal insulin regimens: an analysis from the OpT2mise randomized trial. Diabetes Obes Metab. 2017;19(10):1490-1494.
      Zöllner YF, Ziegler R, Stüve M, Krumreich J, Schauf M. Event and cost offsets of switching 20% of the type 1 diabetes population in Germany from multiple daily injections to continuous subcutaneous insulin infusion: a 4-year simulation model. J Diabetes Sci Technol. 2016;10(5):1142-1148.
      Zabeen B, Craig ME, Virk SA, et al. Insulin pump therapy is associated with lower rates of retinopathy and peripheral nerve abnormality. PLoS ONE. 2016;11(4):e0153033.
      Marchand L, Kawasaki-Ogita Y, Place J, et al. Long-term effects of continuous subcutaneous insulin infusion on glucose control and microvascular complications in patients with type 1 diabetes. J Diabetes Sci Technol. 2017;11(5):924-929.
      Tubili C, Folco UD, Nardone MR, Clementi A. A single-center long-term continuous subcutaneous insulin infusion (CSII) experience: higher fractional use is associated with less diabetes complications. J Diabetes Sci Technol. 2017;11(5):1057-1058.
      Pickup JC, Reznik Y, Sutton AJ. Glycemic control during continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 2 diabetes: individual patient data meta-analysis and meta-regression of randomized controlled trials. Diabetes Care. 2017;40(5):715-722.
      Jeitler K, Horvath K, Berghold A, et al. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis. Diabetologia. 2008;51(6):941-951.
      Li Y, Xu W, Liao Z. Induction of long-term glycemic control in newly diagnosed type 2 diabetic patients is associated with improvement of beta-cell function. Diabetes Care. 2004;27(11):2597-2602.
      Noh YH, Lee SM, Kim EJ, et al. Improvement of cardiovascular risk factors in patients with type 2 diabetes after long-term continuous subcutaneous insulin infusion. Diabetes Metab Res Rev. 2008;24(5):384-391.
      Steineck I, Cederholm J, Eliasson B, et al. Swedish National Diabetes Register. Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18,168 people with type 1 diabetes: observational study. BMJ. 2015;350:h3234. https://doi.org/10.1136/bmj.h3234.
      Piechowiak K, Szypowska A. Physiological factors influencing diabetes control in type 1 diabetes children with insulin pumps from diagnosis. Diabetes Metab Res Rev. 2019;35(1):e3086.
      Skylar JS, Ponder S, Kruger DF, Matheson D, Parkin CG. Is there a place for insulin pump therapy in your practice? Clin Diabetes. 2007;25(2):50-56.
      Ackermann RT, Wallia A, Kang R, et al. Comparative effectiveness and costs of insulin pump therapy for diabetes. Am J Manag Care. 2017;23(6):353-359.
    • Contributed Indexing:
      Keywords: cardiovascular events; continuous subcutaneous insulin infusion; multiple daily injection
    • Accession Number:
      0 (Biomarkers)
      0 (Blood Glucose)
      0 (Glycated Hemoglobin A)
      0 (Hypoglycemic Agents)
      0 (hemoglobin A1c protein, human)
    • Publication Date:
      Date Created: 20191024 Date Completed: 20201201 Latest Revision: 20221207
    • Publication Date:
      20240628
    • Accession Number:
      10.1002/dmrr.3219
    • Accession Number:
      31642581