The impact of continuous subcutaneous insulin infusion and multiple daily injections of insulin on glucose variability in older adults with type 2 diabetes

Susan L. Johnson, Laura N. McEwen, Christopher A. Newton, Catherine L. Martin, Philip Raskin, Jeffrey B. Halter, William H. Herman

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Aims: To determine whether continuous subcutaneous insulin infusion (CSII) or multiple daily injections of insulin (MDI) are associated with improved glycemic variability. Methods: Type 2 diabetic patients ≥ 60 years of age were randomized to 12 months of CSII (n=53) or MDI (n=54) therapy. Patients were asked to complete monthly eight-point self-monitored glucose profiles (n=78) and continuous glucose monitoring systems (CGMS) for up to 72 h at Months 0, 6, and 12 (n=77). Within-day mean glucose, standard deviation (SD), range, pre- and post-prandial glucose, M value, and mean amplitude of glycemic excursions (MAGE) were calculated from eight-point profiles. Mean glucose, SD, range, area under the curve (AUC) high (>180 mg/dl) and AUC-low (<70 mg/dl) were calculated from CGMS. Mixed model analyses of variance were used to examine the associations between treatment, time, and the study outcomes, adjusting for any effects of sex. Results: With the use of the eight-point profiles, CSII and MDI groups did not differ with respect to mean glucose, mean pre-prandial and post-prandial glucose, SD, range, M value, or MAGE. With the CGMS data, there were no significant between-group differences in measures of mean glucose, range, SD, AUC-high, or AUC-low. In both treatment groups, all measures improved over time (P<.0001) except for AUC-low (P=.68) which did not change. There were treatment-by-time interactions when considering the CGMS range (P=.04) and AUC-high (P=.001), but no significant differences were found at individual time points. Conclusions: Glucose variability improved equally with CSII and MDI treatment in older patients with type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)211-215
Number of pages5
JournalJournal of Diabetes and its Complications
Volume25
Issue number4
DOIs
StatePublished - Jul 2011

Fingerprint

Subcutaneous Infusions
Type 2 Diabetes Mellitus
Insulin
Glucose
Injections
Area Under Curve
Meals
Therapeutics
Time and Motion Studies
Information Systems
Analysis of Variance

Keywords

  • Continuous subcutaneous insulin infusion (CSII)
  • Glucose variability
  • Multiple daily injections of insulin (MDI)
  • Older adults
  • Type 2 diabetes

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

The impact of continuous subcutaneous insulin infusion and multiple daily injections of insulin on glucose variability in older adults with type 2 diabetes. / Johnson, Susan L.; McEwen, Laura N.; Newton, Christopher A.; Martin, Catherine L.; Raskin, Philip; Halter, Jeffrey B.; Herman, William H.

In: Journal of Diabetes and its Complications, Vol. 25, No. 4, 07.2011, p. 211-215.

Research output: Contribution to journalArticle

Johnson, Susan L. ; McEwen, Laura N. ; Newton, Christopher A. ; Martin, Catherine L. ; Raskin, Philip ; Halter, Jeffrey B. ; Herman, William H. / The impact of continuous subcutaneous insulin infusion and multiple daily injections of insulin on glucose variability in older adults with type 2 diabetes. In: Journal of Diabetes and its Complications. 2011 ; Vol. 25, No. 4. pp. 211-215.
@article{9571032f8b374bc59a54b76a6c8c0964,
title = "The impact of continuous subcutaneous insulin infusion and multiple daily injections of insulin on glucose variability in older adults with type 2 diabetes",
abstract = "Aims: To determine whether continuous subcutaneous insulin infusion (CSII) or multiple daily injections of insulin (MDI) are associated with improved glycemic variability. Methods: Type 2 diabetic patients ≥ 60 years of age were randomized to 12 months of CSII (n=53) or MDI (n=54) therapy. Patients were asked to complete monthly eight-point self-monitored glucose profiles (n=78) and continuous glucose monitoring systems (CGMS) for up to 72 h at Months 0, 6, and 12 (n=77). Within-day mean glucose, standard deviation (SD), range, pre- and post-prandial glucose, M value, and mean amplitude of glycemic excursions (MAGE) were calculated from eight-point profiles. Mean glucose, SD, range, area under the curve (AUC) high (>180 mg/dl) and AUC-low (<70 mg/dl) were calculated from CGMS. Mixed model analyses of variance were used to examine the associations between treatment, time, and the study outcomes, adjusting for any effects of sex. Results: With the use of the eight-point profiles, CSII and MDI groups did not differ with respect to mean glucose, mean pre-prandial and post-prandial glucose, SD, range, M value, or MAGE. With the CGMS data, there were no significant between-group differences in measures of mean glucose, range, SD, AUC-high, or AUC-low. In both treatment groups, all measures improved over time (P<.0001) except for AUC-low (P=.68) which did not change. There were treatment-by-time interactions when considering the CGMS range (P=.04) and AUC-high (P=.001), but no significant differences were found at individual time points. Conclusions: Glucose variability improved equally with CSII and MDI treatment in older patients with type 2 diabetes.",
keywords = "Continuous subcutaneous insulin infusion (CSII), Glucose variability, Multiple daily injections of insulin (MDI), Older adults, Type 2 diabetes",
author = "Johnson, {Susan L.} and McEwen, {Laura N.} and Newton, {Christopher A.} and Martin, {Catherine L.} and Philip Raskin and Halter, {Jeffrey B.} and Herman, {William H.}",
year = "2011",
month = "7",
doi = "10.1016/j.jdiacomp.2010.09.005",
language = "English (US)",
volume = "25",
pages = "211--215",
journal = "Journal of Diabetes and its Complications",
issn = "1056-8727",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - The impact of continuous subcutaneous insulin infusion and multiple daily injections of insulin on glucose variability in older adults with type 2 diabetes

AU - Johnson, Susan L.

AU - McEwen, Laura N.

AU - Newton, Christopher A.

AU - Martin, Catherine L.

AU - Raskin, Philip

AU - Halter, Jeffrey B.

AU - Herman, William H.

PY - 2011/7

Y1 - 2011/7

N2 - Aims: To determine whether continuous subcutaneous insulin infusion (CSII) or multiple daily injections of insulin (MDI) are associated with improved glycemic variability. Methods: Type 2 diabetic patients ≥ 60 years of age were randomized to 12 months of CSII (n=53) or MDI (n=54) therapy. Patients were asked to complete monthly eight-point self-monitored glucose profiles (n=78) and continuous glucose monitoring systems (CGMS) for up to 72 h at Months 0, 6, and 12 (n=77). Within-day mean glucose, standard deviation (SD), range, pre- and post-prandial glucose, M value, and mean amplitude of glycemic excursions (MAGE) were calculated from eight-point profiles. Mean glucose, SD, range, area under the curve (AUC) high (>180 mg/dl) and AUC-low (<70 mg/dl) were calculated from CGMS. Mixed model analyses of variance were used to examine the associations between treatment, time, and the study outcomes, adjusting for any effects of sex. Results: With the use of the eight-point profiles, CSII and MDI groups did not differ with respect to mean glucose, mean pre-prandial and post-prandial glucose, SD, range, M value, or MAGE. With the CGMS data, there were no significant between-group differences in measures of mean glucose, range, SD, AUC-high, or AUC-low. In both treatment groups, all measures improved over time (P<.0001) except for AUC-low (P=.68) which did not change. There were treatment-by-time interactions when considering the CGMS range (P=.04) and AUC-high (P=.001), but no significant differences were found at individual time points. Conclusions: Glucose variability improved equally with CSII and MDI treatment in older patients with type 2 diabetes.

AB - Aims: To determine whether continuous subcutaneous insulin infusion (CSII) or multiple daily injections of insulin (MDI) are associated with improved glycemic variability. Methods: Type 2 diabetic patients ≥ 60 years of age were randomized to 12 months of CSII (n=53) or MDI (n=54) therapy. Patients were asked to complete monthly eight-point self-monitored glucose profiles (n=78) and continuous glucose monitoring systems (CGMS) for up to 72 h at Months 0, 6, and 12 (n=77). Within-day mean glucose, standard deviation (SD), range, pre- and post-prandial glucose, M value, and mean amplitude of glycemic excursions (MAGE) were calculated from eight-point profiles. Mean glucose, SD, range, area under the curve (AUC) high (>180 mg/dl) and AUC-low (<70 mg/dl) were calculated from CGMS. Mixed model analyses of variance were used to examine the associations between treatment, time, and the study outcomes, adjusting for any effects of sex. Results: With the use of the eight-point profiles, CSII and MDI groups did not differ with respect to mean glucose, mean pre-prandial and post-prandial glucose, SD, range, M value, or MAGE. With the CGMS data, there were no significant between-group differences in measures of mean glucose, range, SD, AUC-high, or AUC-low. In both treatment groups, all measures improved over time (P<.0001) except for AUC-low (P=.68) which did not change. There were treatment-by-time interactions when considering the CGMS range (P=.04) and AUC-high (P=.001), but no significant differences were found at individual time points. Conclusions: Glucose variability improved equally with CSII and MDI treatment in older patients with type 2 diabetes.

KW - Continuous subcutaneous insulin infusion (CSII)

KW - Glucose variability

KW - Multiple daily injections of insulin (MDI)

KW - Older adults

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=79959924564&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79959924564&partnerID=8YFLogxK

U2 - 10.1016/j.jdiacomp.2010.09.005

DO - 10.1016/j.jdiacomp.2010.09.005

M3 - Article

C2 - 21062674

AN - SCOPUS:79959924564

VL - 25

SP - 211

EP - 215

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

SN - 1056-8727

IS - 4

ER -