Effectiveness of Intensive Insulin Therapy by Multiple Daily Injections and Continuous Subcutaneous Infusion: A Comparison Study in Type 2 Diabetes with Conventional Insulin Regimen Failure
Abstract OBJECTIVE: To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy. RESEARCH DESIGN AND METHODS: Seventeen type 2 diabetes patients unco...
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| Veröffentlicht in: | Hormone and metabolic research 2007-03, Vol.39 (3), p.224-229 |
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| container_title | Hormone and metabolic research |
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| creator | Berthe, E. Lireux, B. Coffin, C. Goulet-Salmon, B. Houlbert, D. Boutreux, S. Fradin, S. Reznik, Y. |
| description | Abstract
OBJECTIVE: To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy.
RESEARCH DESIGN AND METHODS: Seventeen type 2 diabetes patients uncontrolled by two daily injections of regular plus NPH were randomly assigned in a cross-over fashion to either three daily injections of lispro plus NPH or pump device delivering lispro. HbA1c, 6 points capillary blood glucose, 24-hour continuous glucose monitoring system tracings and global satisfaction score were evaluated at the end of each 12-week treatment period.
RESULTS: HbA1c decreased from 9.0±1.6% to 8.6±1.6% with multiple injections and 7.7±0.8% with pump device (p |
| doi_str_mv | 10.1055/s-2007-970423 |
| format | Article |
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OBJECTIVE: To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy.
RESEARCH DESIGN AND METHODS: Seventeen type 2 diabetes patients uncontrolled by two daily injections of regular plus NPH were randomly assigned in a cross-over fashion to either three daily injections of lispro plus NPH or pump device delivering lispro. HbA1c, 6 points capillary blood glucose, 24-hour continuous glucose monitoring system tracings and global satisfaction score were evaluated at the end of each 12-week treatment period.
RESULTS: HbA1c decreased from 9.0±1.6% to 8.6±1.6% with multiple injections and 7.7±0.8% with pump device (p<0.03). Capillary blood glucose was lowered at all time-points with pump, but only at morning with multiple injections (p<0.01). Compared to conventional therapy, pump reduced hyperglycemic area under curve by 73% (p<0.01), but multiple injections by only 32% (p=0.08). Rate of hypoglycemia was not increased and patient's satisfaction was comparable with both intensive treatments.
CONCLUSIONS: Pump therapy provides a better metabolic control than injection regimens, and seems to be safe and convenient in patients with type 2 diabetes who fail to respond to conventional insulin therapy.</description><identifier>ISSN: 0018-5043</identifier><identifier>EISSN: 1439-4286</identifier><identifier>DOI: 10.1055/s-2007-970423</identifier><identifier>PMID: 17373639</identifier><language>eng</language><publisher>Germany</publisher><subject>Administration, Cutaneous ; Area Under Curve ; Blood Glucose - analysis ; Diabetes Mellitus, Type 2 - drug therapy ; Drug Administration Schedule ; Female ; Glycated Hemoglobin A ; Hemoglobins - metabolism ; Humans ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - therapeutic use ; Injections, Subcutaneous ; Insulin - administration & dosage ; Insulin - analogs & derivatives ; Insulin - pharmacology ; Insulin - therapeutic use ; Insulin Infusion Systems ; Insulin Lispro ; Male ; Middle Aged ; Monitoring, Physiologic ; Original Clinical ; Patient Satisfaction ; Surveys and Questionnaires ; Treatment Failure</subject><ispartof>Hormone and metabolic research, 2007-03, Vol.39 (3), p.224-229</ispartof><rights>Georg Thieme Verlag KG Stuttgart · New York</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c328t-42bce56b4050665677ba22cd924dbbfccabe63b8dcfb7a3e1e8d91d4de6f7d333</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-2007-970423.pdf$$EPDF$$P50$$Gthieme$$H</linktopdf><linktohtml>$$Uhttps://www.thieme-connect.de/products/ejournals/html/10.1055/s-2007-970423$$EHTML$$P50$$Gthieme$$H</linktohtml><link.rule.ids>314,776,780,3004,3005,27901,27902,54534,54535</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17373639$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berthe, E.</creatorcontrib><creatorcontrib>Lireux, B.</creatorcontrib><creatorcontrib>Coffin, C.</creatorcontrib><creatorcontrib>Goulet-Salmon, B.</creatorcontrib><creatorcontrib>Houlbert, D.</creatorcontrib><creatorcontrib>Boutreux, S.</creatorcontrib><creatorcontrib>Fradin, S.</creatorcontrib><creatorcontrib>Reznik, Y.</creatorcontrib><title>Effectiveness of Intensive Insulin Therapy by Multiple Daily Injections and Continuous Subcutaneous Infusion: A Comparison Study in Type 2 Diabetes with Conventional Insulin Regimen Failure</title><title>Hormone and metabolic research</title><addtitle>Horm Metab Res</addtitle><description>Abstract
OBJECTIVE: To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy.
RESEARCH DESIGN AND METHODS: Seventeen type 2 diabetes patients uncontrolled by two daily injections of regular plus NPH were randomly assigned in a cross-over fashion to either three daily injections of lispro plus NPH or pump device delivering lispro. HbA1c, 6 points capillary blood glucose, 24-hour continuous glucose monitoring system tracings and global satisfaction score were evaluated at the end of each 12-week treatment period.
RESULTS: HbA1c decreased from 9.0±1.6% to 8.6±1.6% with multiple injections and 7.7±0.8% with pump device (p<0.03). Capillary blood glucose was lowered at all time-points with pump, but only at morning with multiple injections (p<0.01). Compared to conventional therapy, pump reduced hyperglycemic area under curve by 73% (p<0.01), but multiple injections by only 32% (p=0.08). Rate of hypoglycemia was not increased and patient's satisfaction was comparable with both intensive treatments.
CONCLUSIONS: Pump therapy provides a better metabolic control than injection regimens, and seems to be safe and convenient in patients with type 2 diabetes who fail to respond to conventional insulin therapy.</description><subject>Administration, Cutaneous</subject><subject>Area Under Curve</subject><subject>Blood Glucose - analysis</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Glycated Hemoglobin A</subject><subject>Hemoglobins - metabolism</subject><subject>Humans</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Injections, Subcutaneous</subject><subject>Insulin - administration & dosage</subject><subject>Insulin - analogs & derivatives</subject><subject>Insulin - pharmacology</subject><subject>Insulin - therapeutic use</subject><subject>Insulin Infusion Systems</subject><subject>Insulin Lispro</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Monitoring, Physiologic</subject><subject>Original Clinical</subject><subject>Patient Satisfaction</subject><subject>Surveys and Questionnaires</subject><subject>Treatment Failure</subject><issn>0018-5043</issn><issn>1439-4286</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxS0EokvhyBX5xImAEztxwq3atrBSERIt58h_JqxXiRMydlE-HN8NR1nBiZM9o5_fG88j5HXO3uesLD9gVjAms0YyUfAnZJcL3mSiqKunZMdYXmclE_yCvEA8pVI0uXhOLnLJJa94syO_b7oOTHCP4AGRjh09-AAeUyPdMPbO04cjzGpaqF7ol9gHN_VAr5Xrl0Sc1sejR6q8pfvRB-fjGJHeR21iUB7W4uC7iIn6SK8SM0xqdjh6eh-iXehqsExAC3rtlIYASH-5cFzF0lCruOr_jvINfrgBPL1N9nGGl-RZp3qEV-fzkny_vXnYf87uvn467K_uMsOLOqR1aANlpQUrWVWVlZRaFYWxTSGs1p0xybfiuram01JxyKG2TW6FhaqTlnN-Sd5uutM8_oyAoR0cGuj77YOtZEVTl6JMYLaBZh4RZ-jaaXaDmpc2Z-2aV4vtmle75ZX4N2fhqAew_-hzQAl4twHh6GCA9jTGOS0E_6P3ByGlo6c</recordid><startdate>20070301</startdate><enddate>20070301</enddate><creator>Berthe, E.</creator><creator>Lireux, B.</creator><creator>Coffin, C.</creator><creator>Goulet-Salmon, B.</creator><creator>Houlbert, D.</creator><creator>Boutreux, S.</creator><creator>Fradin, S.</creator><creator>Reznik, Y.</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20070301</creationdate><title>Effectiveness of Intensive Insulin Therapy by Multiple Daily Injections and Continuous Subcutaneous Infusion: A Comparison Study in Type 2 Diabetes with Conventional Insulin Regimen Failure</title><author>Berthe, E. ; Lireux, B. ; Coffin, C. ; Goulet-Salmon, B. ; Houlbert, D. ; Boutreux, S. ; Fradin, S. ; Reznik, Y.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c328t-42bce56b4050665677ba22cd924dbbfccabe63b8dcfb7a3e1e8d91d4de6f7d333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Administration, Cutaneous</topic><topic>Area Under Curve</topic><topic>Blood Glucose - analysis</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Glycated Hemoglobin A</topic><topic>Hemoglobins - metabolism</topic><topic>Humans</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Injections, Subcutaneous</topic><topic>Insulin - administration & dosage</topic><topic>Insulin - analogs & derivatives</topic><topic>Insulin - pharmacology</topic><topic>Insulin - therapeutic use</topic><topic>Insulin Infusion Systems</topic><topic>Insulin Lispro</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Monitoring, Physiologic</topic><topic>Original Clinical</topic><topic>Patient Satisfaction</topic><topic>Surveys and Questionnaires</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Berthe, E.</creatorcontrib><creatorcontrib>Lireux, B.</creatorcontrib><creatorcontrib>Coffin, C.</creatorcontrib><creatorcontrib>Goulet-Salmon, B.</creatorcontrib><creatorcontrib>Houlbert, D.</creatorcontrib><creatorcontrib>Boutreux, S.</creatorcontrib><creatorcontrib>Fradin, S.</creatorcontrib><creatorcontrib>Reznik, Y.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hormone and metabolic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Berthe, E.</au><au>Lireux, B.</au><au>Coffin, C.</au><au>Goulet-Salmon, B.</au><au>Houlbert, D.</au><au>Boutreux, S.</au><au>Fradin, S.</au><au>Reznik, Y.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of Intensive Insulin Therapy by Multiple Daily Injections and Continuous Subcutaneous Infusion: A Comparison Study in Type 2 Diabetes with Conventional Insulin Regimen Failure</atitle><jtitle>Hormone and metabolic research</jtitle><addtitle>Horm Metab Res</addtitle><date>2007-03-01</date><risdate>2007</risdate><volume>39</volume><issue>3</issue><spage>224</spage><epage>229</epage><pages>224-229</pages><issn>0018-5043</issn><eissn>1439-4286</eissn><abstract>Abstract
OBJECTIVE: To compare the effectiveness of two intensified insulin regimens, i.e., pump delivery versus multiple daily injections in patients with type 2 diabetes not optimally controlled with conventional insulin therapy.
RESEARCH DESIGN AND METHODS: Seventeen type 2 diabetes patients uncontrolled by two daily injections of regular plus NPH were randomly assigned in a cross-over fashion to either three daily injections of lispro plus NPH or pump device delivering lispro. HbA1c, 6 points capillary blood glucose, 24-hour continuous glucose monitoring system tracings and global satisfaction score were evaluated at the end of each 12-week treatment period.
RESULTS: HbA1c decreased from 9.0±1.6% to 8.6±1.6% with multiple injections and 7.7±0.8% with pump device (p<0.03). Capillary blood glucose was lowered at all time-points with pump, but only at morning with multiple injections (p<0.01). Compared to conventional therapy, pump reduced hyperglycemic area under curve by 73% (p<0.01), but multiple injections by only 32% (p=0.08). Rate of hypoglycemia was not increased and patient's satisfaction was comparable with both intensive treatments.
CONCLUSIONS: Pump therapy provides a better metabolic control than injection regimens, and seems to be safe and convenient in patients with type 2 diabetes who fail to respond to conventional insulin therapy.</abstract><cop>Germany</cop><pmid>17373639</pmid><doi>10.1055/s-2007-970423</doi><tpages>6</tpages></addata></record> |
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| subjects | Administration, Cutaneous Area Under Curve Blood Glucose - analysis Diabetes Mellitus, Type 2 - drug therapy Drug Administration Schedule Female Glycated Hemoglobin A Hemoglobins - metabolism Humans Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - therapeutic use Injections, Subcutaneous Insulin - administration & dosage Insulin - analogs & derivatives Insulin - pharmacology Insulin - therapeutic use Insulin Infusion Systems Insulin Lispro Male Middle Aged Monitoring, Physiologic Original Clinical Patient Satisfaction Surveys and Questionnaires Treatment Failure |
| title | Effectiveness of Intensive Insulin Therapy by Multiple Daily Injections and Continuous Subcutaneous Infusion: A Comparison Study in Type 2 Diabetes with Conventional Insulin Regimen Failure |
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