TY - JOUR
T1 - A clinical trial of continuous subcutaneous insulin infusion versus multiple daily injections in older adults with type 2 diabetes
AU - Herman, William H.
AU - Ilag, Liza L.
AU - Johnson, Susan L.
AU - Martin, Catherine L.
AU - Sinding, Joyce
AU - Al Harthi, Abdulaziz
AU - Plunkett, Cynthia D.
AU - LaPorte, Frankie B.
AU - Burke, Ray
AU - Brown, Morton B.
AU - Halter, Jeffery B.
AU - Raskin, Philip
N1 - Funding Information:
The Sloane Project is grateful to Public Health England (formerly the NHS Breast Screening Programme) for financial support. The Sloane Project has previously been supported by Pfizer Pharmaceuticals, the Breast Cancer Research Trust, and ad-hoc private donations. None of the funding sources, past or present, have had input into the writing of this manuscript or the decision to submit it for publication. Members of the Steering Group listed below give their time voluntarily to the Sloane Project.
PY - 2005/7
Y1 - 2005/7
N2 - OBJECTIVE- To compare the efficacy and safety of continuous subcutaneous insulin infusion (CSII) and multiple daily injection (MDI) in older adults with insulin-treated type 2 diabetes and to assess treatment satisfaction and quality of life. RESEARCH DESIGN AND METHODS- Adults (n = 107) ≥60 years of age (mean age 66 years) with insulin-treated type 2 diabetes (mean duration 16 years, BMI 32 kg/m2, and HbA1C-[A1C] 8.2%) were randomized 10 CSII (using insulin lispro) or MDI (using insulin lispro and insulin glargine) in a two-center, 12-month, prospective, randomized, controlled clinical trial. Efficacy was assessed with A1C, safely by frequency of hypoglycemia, and treatment satisfaction and quality of Life with the Diabetes Quality of Life Clinical Trial Questionnaire and the 36-item short-form health survey, version 2. RESULTS- Forty-eight CSII subjects (91%) and 50 MDI subjects (93%) completed the study. Mean A1C fell by 1.7 ± 1.0% in the CSII group to 6.6% and by 1.6 ± 1.2% in the MDI group to 6.4%. The difference in A1C between treatment groups was not statistically significant (P = 0.20). Eighty-one percent of CSII subjects and 90% of MDI subjects experienced at least one episode of minor (self-treated) hypoglycemia (P = 0.17), and three CSII and six MDI subjects experienced severe hypoglycemia (P = 0.49). Rates of severe hypoglycemia were similarly low in the two groups (CSII 0.08 and MDI 0.23 events per person-year, P = 0.61). Weight gain did not differ between groups (P = 0.70). Treatment satisfaction improved significantly with both CSII and MDI (P < 0.0001), and the difference between groups was not statistically significant (P = 0.58). CONCLUSIONS- In older subjects with insulin-treated type 2 diabetes, both CSII and MDI achieved excellent glycemic control with good safety and patient satisfaction.
AB - OBJECTIVE- To compare the efficacy and safety of continuous subcutaneous insulin infusion (CSII) and multiple daily injection (MDI) in older adults with insulin-treated type 2 diabetes and to assess treatment satisfaction and quality of life. RESEARCH DESIGN AND METHODS- Adults (n = 107) ≥60 years of age (mean age 66 years) with insulin-treated type 2 diabetes (mean duration 16 years, BMI 32 kg/m2, and HbA1C-[A1C] 8.2%) were randomized 10 CSII (using insulin lispro) or MDI (using insulin lispro and insulin glargine) in a two-center, 12-month, prospective, randomized, controlled clinical trial. Efficacy was assessed with A1C, safely by frequency of hypoglycemia, and treatment satisfaction and quality of Life with the Diabetes Quality of Life Clinical Trial Questionnaire and the 36-item short-form health survey, version 2. RESULTS- Forty-eight CSII subjects (91%) and 50 MDI subjects (93%) completed the study. Mean A1C fell by 1.7 ± 1.0% in the CSII group to 6.6% and by 1.6 ± 1.2% in the MDI group to 6.4%. The difference in A1C between treatment groups was not statistically significant (P = 0.20). Eighty-one percent of CSII subjects and 90% of MDI subjects experienced at least one episode of minor (self-treated) hypoglycemia (P = 0.17), and three CSII and six MDI subjects experienced severe hypoglycemia (P = 0.49). Rates of severe hypoglycemia were similarly low in the two groups (CSII 0.08 and MDI 0.23 events per person-year, P = 0.61). Weight gain did not differ between groups (P = 0.70). Treatment satisfaction improved significantly with both CSII and MDI (P < 0.0001), and the difference between groups was not statistically significant (P = 0.58). CONCLUSIONS- In older subjects with insulin-treated type 2 diabetes, both CSII and MDI achieved excellent glycemic control with good safety and patient satisfaction.
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U2 - 10.2337/diacare.28.7.1568
DO - 10.2337/diacare.28.7.1568
M3 - Article
C2 - 15983302
AN - SCOPUS:21544436847
SN - 0149-5992
VL - 28
SP - 1568
EP - 1573
JO - Diabetes care
JF - Diabetes care
IS - 7
ER -