Non-Stop Insulin Better for Glycemic Control

Aug 16, 2009
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Dutch researchers report that in patients with Type 1 diabetes, continuous intraperitoneal insulin infusion (CIPII) using an implantable pump achieves a higher degree of euglycemia than do multiple daily insulin injections.

Lead investigator Dr. Susan J. Logtenberg stated that, “With CIPII, compared to intensive subcutaneous insulin regimens, it is possible to reach better glycemic control in terms of A1c, and subjects spend more time in euglycemia without the occurrence of more hypoglycemic events.”

Dr. Logtenberg of Isala Clinics, Zwolle, and colleagues, came to this conclusion after an open-label, 16-month, randomized crossover study in 24 patients.

With CIPII, the weekly incidence of grade 1 hypoglycemic events was 3.5, compared to 4.0 with subcutaneous injection. The absolute mean A1c was 0.76% lower with CIPII.

Baseline time spent in euglycemia was 45.2%. This proportion increased with CIPII, and with injection it fell. After adjustment, the difference amounted to 10.9%.

The researchers point out that the approach is expensive but, “We recommend consideration of CIPII as a treatment option for those patients with Type 1 diabetes who fail to achieve satisfactory glycemic control with other intensive insulin treatment regimens.”

Given the encouraging findings, Dr. Logtenberg added that, “In the near future we hope to report about the effects on quality of life, as well.”

Diabetes Care Aug, 2009;32:1372-1377.