Document Detail


Insulin pump therapy in patients with type 2 diabetes safely improved glycemic control using a simple insulin dosing regimen.
MedLine Citation:
PMID:  20615104     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study assessed insulin dose and dosing patterns required to optimize glycemic control with an insulin pump in patients with type 2 diabetes. METHODS: In this 16-week, open-label, multicenter, pilot study, 56 insulin pump-naive patients treated at baseline with two or more oral antidiabetes agents (OADs), basal insulin with or without OADs, or basal-bolus insulin with or without OADs discontinued all diabetes medications except metformin and initiated insulin pump therapy. Insulin doses were adjusted to optimize glycemic control with the simplest possible insulin regimen. Outcomes included total daily insulin dose, daily basal and bolus insulin doses, number of daily basal rates, hemoglobin A1C, fasting and postprandial glucose, patient-reported outcomes and rate of hypoglycemia. RESULTS: After 16 weeks of pump therapy, the mean +/- SD total daily insulin dose was 95 +/- 59 U. The percentage of the total daily insulin dose used as basal and as bolus delivery was 55% and 45%, respectively. Eighty-eight percent of patients were treated with two or fewer daily basal rates. Mean A1C was lowered by 1.2 +/- 1.2% (P < 0.001), and there was no severe hypoglycemia. Mean change in body weight was +1.9 +/- 3.3 kg (P < 0.001). Overall treatment preference improved with pump therapy compared to baseline. CONCLUSIONS: Insulin pump therapy using a simple dosing regimen significantly improved glycemic control in patients with type 2 diabetes. Patients experienced limited weight gain, there was no severe hypoglycemia, and overall treatment preference improved significantly.
Authors:
Steven V Edelman; Bruce W Bode; Timothy S Bailey; Mark S Kipnes; Rocco Brunelle; Xiaojing Chen; Juan P Frias
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetes technology & therapeutics     Volume:  12     ISSN:  1557-8593     ISO Abbreviation:  Diabetes Technol. Ther.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889084     Medline TA:  Diabetes Technol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-33     Citation Subset:  IM    
Affiliation:
University of California, San Diego, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Glucose / metabolism
Blood Glucose Self-Monitoring
Diabetes Mellitus, Type 2 / blood,  drug therapy*
Drug Administration Schedule
Drug Therapy, Combination
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Hypoglycemic Agents / administration & dosage,  therapeutic use
Insulin / administration & dosage,  analogs & derivatives*,  therapeutic use
Insulin Infusion Systems*
Intention to Treat Analysis
Male
Metformin / administration & dosage,  therapeutic use
Middle Aged
Patient Selection
Pilot Projects
Treatment Outcome
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 11061-68-0/Insulin; 207748-29-6/insulin glulisine; 657-24-9/Metformin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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