M Monami1, C Lamanna, N Marchionni, E Mannucci. 1. Section of Geriatric Cardiology, Department of Cardiovascular Medicine, Azienda Ospedaliero-Universitaria Careggi, Via delle Oblate 4, Florence, Italy. mmonami@libero.it
Abstract
BACKGROUND: Continuous Subcutaneous Insulin Infusion (CSII) improves HbA1c in type 1 diabetic patients unsatisfactorily controlled by Multiple Daily Injections (MDI). Few trials have explored CSII for basal-bolus therapy in type 2 diabetes. MATERIALS AND METHODS: Randomized Clinical Trials (RCTs) comparing CSII and MDI for at least 12 weeks in type 2 diabetic patients were retrieved, assessing between-group differences in HbA1c and insulin daily dose at endpoint, and incidence of hypoglycemia. RESULTS: A total of 4 RCTs was included in the analysis. CSII did not produce any significant improvement of HbA1c in comparison with MDI (Standardized difference in mean: 0.09(-0.08;0.26)%; p=0.31). No significant difference was observed in the rate of hypoglycemic episodes. CSII was associated with a nonsignificant trend toward the reduction of insulin doses used at the end of trial. CONCLUSIONS: Available data do not justify the use of CSII for basal-bolus insulin therapy in type 2 diabetes.
BACKGROUND: Continuous Subcutaneous Insulin Infusion (CSII) improves HbA1c in type 1 diabeticpatients unsatisfactorily controlled by Multiple Daily Injections (MDI). Few trials have explored CSII for basal-bolus therapy in type 2 diabetes. MATERIALS AND METHODS: Randomized Clinical Trials (RCTs) comparing CSII and MDI for at least 12 weeks in type 2 diabeticpatients were retrieved, assessing between-group differences in HbA1c and insulin daily dose at endpoint, and incidence of hypoglycemia. RESULTS: A total of 4 RCTs was included in the analysis. CSII did not produce any significant improvement of HbA1c in comparison with MDI (Standardized difference in mean: 0.09(-0.08;0.26)%; p=0.31). No significant difference was observed in the rate of hypoglycemic episodes. CSII was associated with a nonsignificant trend toward the reduction of insulin doses used at the end of trial. CONCLUSIONS: Available data do not justify the use of CSII for basal-bolus insulin therapy in type 2 diabetes.