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Effectiveness of multiple daily injections or continuous subcutaneous insulin infusion for children with type 1 diabetes mellitus in clinical practice.

Gong CX, Wei LY, Wu D, Cao BY, Meng X, Wang LL - Int J Endocrinol (2014)

Bottom Line: HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; all P < 0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%; P = 0.04).Conclusions.Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation.

View Article: PubMed Central - PubMed

Affiliation: Beijing Children's Hospital Affiliated with Capital Medical University, 56 South Lishi Road, Xicheng District, Beijing 100045, China.

ABSTRACT
Aims. To determine whether multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) contributes to better glucose control in children with different type 1 diabetes duration. Methods. Subjects were grouped according to early (≤1 year after disease onset; 1A) or late (1-3 years after onset; 2A) MDIs/CSII treatment initiation. Corresponding control groups (1B, 2B) received insulin injections twice daily. Results. HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; all P < 0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%; P = 0.04). Levels were lower in group 1A than in group 2A when disease duration was matched (7.61% versus 8.49%; P < 0.05). Logistic regression revealed no correlation between HbA1c level and MDIs/CSII therapy. HbA1c levels were only negatively related to insulin dosage. Conclusions. Blood glucose control was better in patients receiving MDIs/CSII than in those receiving conventional treatment. Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation. MDIs/CSII therapy should be combined with comprehensive management.

No MeSH data available.


Related in: MedlinePlus

Glycosylated hemoglobin (HbA1c) level (a), insulin dosage (b), body mass index (BMI) (c), and self-monitoring of blood glucose (d) at all observation time points in the control and experimental groups.
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fig1: Glycosylated hemoglobin (HbA1c) level (a), insulin dosage (b), body mass index (BMI) (c), and self-monitoring of blood glucose (d) at all observation time points in the control and experimental groups.

Mentions: HbA1c levels and abnormal control rates were lower in group 1A than in group 1B (both P < 0.05). The comparison of groups 1A and 1B at each observation time point is shown in Table 2. Test of within-subjects effects about HbA1c level indicated that it had a tendency to change with time (disease duration) (F = 4.054, P = 0.005). The HbA1c levels of group 1B were on an upward trend, but it decreased significantly for group 1A at T1 and T2 (P < 0.05; Figure 1(a), Table 2). After 12 months of treatment (T3), the HbA1c level of group 1A began to rise and no longer differed significantly from the baseline value (Figure 1(a), Table 2).


Effectiveness of multiple daily injections or continuous subcutaneous insulin infusion for children with type 1 diabetes mellitus in clinical practice.

Gong CX, Wei LY, Wu D, Cao BY, Meng X, Wang LL - Int J Endocrinol (2014)

Glycosylated hemoglobin (HbA1c) level (a), insulin dosage (b), body mass index (BMI) (c), and self-monitoring of blood glucose (d) at all observation time points in the control and experimental groups.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4150541&req=5

fig1: Glycosylated hemoglobin (HbA1c) level (a), insulin dosage (b), body mass index (BMI) (c), and self-monitoring of blood glucose (d) at all observation time points in the control and experimental groups.
Mentions: HbA1c levels and abnormal control rates were lower in group 1A than in group 1B (both P < 0.05). The comparison of groups 1A and 1B at each observation time point is shown in Table 2. Test of within-subjects effects about HbA1c level indicated that it had a tendency to change with time (disease duration) (F = 4.054, P = 0.005). The HbA1c levels of group 1B were on an upward trend, but it decreased significantly for group 1A at T1 and T2 (P < 0.05; Figure 1(a), Table 2). After 12 months of treatment (T3), the HbA1c level of group 1A began to rise and no longer differed significantly from the baseline value (Figure 1(a), Table 2).

Bottom Line: HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; all P < 0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%; P = 0.04).Conclusions.Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation.

View Article: PubMed Central - PubMed

Affiliation: Beijing Children's Hospital Affiliated with Capital Medical University, 56 South Lishi Road, Xicheng District, Beijing 100045, China.

ABSTRACT
Aims. To determine whether multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) contributes to better glucose control in children with different type 1 diabetes duration. Methods. Subjects were grouped according to early (≤1 year after disease onset; 1A) or late (1-3 years after onset; 2A) MDIs/CSII treatment initiation. Corresponding control groups (1B, 2B) received insulin injections twice daily. Results. HbA1c levels were consistently lower in group 1A than in group 1B (6 months (T2): 7.37% versus 8.21%; 12 months (T3): 7.61% versus 8.41%; 24/36 months (T4/T5): 7.61% versus 8.72%; all P < 0.05), but were lower in group 2A than in group 2B only at T2 (8.36% versus 9.19%; P = 0.04). Levels were lower in group 1A than in group 2A when disease duration was matched (7.61% versus 8.49%; P < 0.05). Logistic regression revealed no correlation between HbA1c level and MDIs/CSII therapy. HbA1c levels were only negatively related to insulin dosage. Conclusions. Blood glucose control was better in patients receiving MDIs/CSII than in those receiving conventional treatment. Early MDIs/CSII initiation resulted in prolonged maintenance of low HbA1c levels compared with late initiation. MDIs/CSII therapy should be combined with comprehensive management.

No MeSH data available.


Related in: MedlinePlus