Comparison of effectiveness of continuous subcutaneous insulin infusion with daily insulin injection in a Chinese population of Type I diabetic patients

Abstract

Purpose: To compare the clinical effectiveness of continuous subcutaneous insulin infusion therapy with that of multiple-dose insulin therapy in type 1 diabetic patients. Methods: A total of 1000 type 1 diabetic patients were assigned to two groups, with 500 patients per group. Patients in group I were treated with continuous subcutaneous infusion of insulin (CSII), while those in group II received multiple daily doses of insulin injection. Body mass index (BMI), insulin dose, HbA1c levels, and frequencies of hypoglycemia and diabetic-ketoacidosis (DKA) were determined in each patient at baseline, and at 4-week intervals for 4 years. Results: The HbA1c levels at baseline and at the end of 4th year in group I were 8.9 ± 1.1 and 8.2 ± 1.5 %, respectively, relative to corresponding values of 8.6 ± 1.2 and 9.1 ± 1.1 %, respectively in group II. The results revealed significant difference in HbA1c between the two groups (p < 0.05). After 4 years of therapy, insulin requirement was markedly higher in group II than at baseline (0.8 ± 0.1 vs 0.9 ± 0.2, p < 0.05) IU/kg/day. However, insulin requirement in group I decreased after 4 years, relative to that at baseline (0.65 ± 0.2 vs 0.8 ± 0.1 IU/kg/day; p < 0.05). Conclusion: CSII therapy seems to be an effective and safe gold standard method for managing type I diabetes mellitus patients.