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[IP] pump therapy vs. MIIT

Endocr Pract 2000 Oct;6(5):357-360  <A HREF="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Link&db=PubMed&dbFrom=PubMed&from_uid=11141585">Related Articles, </A><A HREF="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11141585&dopt=Books">Books</A>     


Bell DS, Ovalle F

Department of Medicine, Division of Endocrinology and Metabolism, University 
of Alabama at Birmingham School of Medicine, Birmingham, Alabama.

[Record supplied by publisher]

OBJECTIVE: To compare, in a long-term study, glycemic control by means of 
continuous subcutaneous insulin infusion (CSII or insulin pump therapy) 
versus multiple insulin injection therapy (MIIT) in routine clinical 
practice. METHODS: We identified, from a search of medical records, all 
active patients (N = 90) receiving CSII who had previously received MIIT. The 
primary objective was to compare the mean glycemic control, as documented by 
frequent measurements of glycosylated hemoglobin (HbA(1c)), during the 3-year 
period before initiation of CSII versus the mean glycemic control during the 
3-year period after the first year of CSII. We included all patients for whom 
we had sufficient data for at least 1 year for both the pre- and post-CSII 
periods and only those patients who had received MIIT before CSII (N = 58). 
To eliminate potential biases, we excluded HbA(1c) values for the first year 
after initiation of CSII therapy. RESULTS: For the entire study group, the 
mean HbA(1c) +/- standard error for the 3-year period before insulin pump 
therapy (during MIIT) was 8.4 +/- 0.2% versus a mean HbA(1c) of 7.7 +/- 0.1% 
for the 3-year period after the first year of CSII. This 0.7% improvement in 
HbA(1c) was statistically significant (P = 0.001). Of the 34 patients with 
HbA(1c) values above 8.0% during MIIT, the mean HbA(1c) decreased from 9.2 
+/- 0.2% with use of MIIT to 8.2 +/- 0.2% with CSII (P = 0.0006). In the 17 
patients with HbA(1c) values above 9.0% during MIIT, the mean HbA(1c) 
declined from 10.0 +/- 0.3% with use of MIIT to 8.4 +/- 0.3% with CSII (P = 
0.0006). CONCLUSION: We conclude that implementation of intensive insulin 
therapy with CSII improves glycemic control, even in patients in whom MIIT 
has previously been used to its maximal effect.

PMID: 11141585   <A HREF="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11141585&dopt=Abstract">Entrez-PubMed</A> 
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