W Gu1, Y Liu2, Y Chen3, W Deng4, X Ran5, L Chen6, D Zhu7, J Yang8, J Shin9, S W Lee10, T L Cordero11, Y Mu12. 1. Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, China. Electronic address: guweijun301@163.com. 2. The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, Jilin Province, China. Electronic address: drliuyu@jlu.edu.cn. 3. Fu Wai Hospital CAMS & PUMC, 167 Beilishi Road, Xi Cheng District, Beijing, China. Electronic address: doc.yan@medmail.com.cn. 4. Beijing Jishuitan Hospital, No. 31, Xin Jie Kou Eastern Street, Western District, Beijing, China. Electronic address: dengwei95@163.com. 5. West China Hospital-Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, China. Electronic address: ranxingwu@163.com. 6. Union Hospital Tongji Medical College, No. 1277, Jiefang Avenue, Wuhan, Hubei Province, China. Electronic address: cheria_chen@126.com. 7. Nanjing Drum Tower Hospital, Nanjing University Medical School, No. 321, Zhongshan, Nanjing, China. Electronic address: zhudalong@nju.edu.cn. 8. Beijing Tongren Hospital, Capital Medical University, No. 1, Dong Jiao Min Xiang, Eastern District, Beijing, China. Electronic address: jinkui.yang@gmail.com. 9. Medtronic, 18000 Devonshire Street, Northridge, CA 91325, United States. Electronic address: john.shin@medtronic.com. 10. Medtronic, 18000 Devonshire Street, Northridge, CA 91325, United States. Electronic address: scott.w.lee@medtronic.com. 11. Medtronic, 18000 Devonshire Street, Northridge, CA 91325, United States. Electronic address: toni.l.cordero@medtronic.com. 12. Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, China. Electronic address: muyiming@301hospital.com.cn.
Abstract
AIM: Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM). METHODS: Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day. RESULTS: When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P<0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P<0.05] and significantly less hyperglycaemia [sensorglucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P<0.05]. CONCLUSION:SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.
RCT Entities:
AIM: Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM). METHODS: Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day. RESULTS: When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P<0.001), while three MDIpatients failed to reach glycaemic targets within 14 days. SAP vs MDIpatients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P<0.05] and significantly less hyperglycaemia [sensor glucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P<0.05]. CONCLUSION:SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.
Authors: Georgia M Davis; Rodolfo J Galindo; Alexandra L Migdal; Guillermo E Umpierrez Journal: Endocrinol Metab Clin North Am Date: 2020-03 Impact factor: 4.741
Authors: Thaer Idrees; Iris A Castro-Revoredo; Alexandra L Migdal; Emmelin Marie Moreno; Guillermo E Umpierrez Journal: BMJ Open Diabetes Res Care Date: 2022-07