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Glyco-metabolic Control, Inflammation Markers, and Cardiovascular Outcomes in Type 1 and Type 2 Diabetic Patients on Insulin Pump or Multiple Daily Injection (Italico Study)
- Publication Year :
- 2020
-
Abstract
- Background To evaluate if the positive effects recorded on glycaemic control with continuous subcutaneous insulin infusion (CSII) were maintained on the long-term compared with multiple daily injection (MDI). The secondary objective was to evaluate if there is a reduction of type and number of cardiovascular events (CV). Methods This retrospective, observational study evaluated glycaemic control and the number of CV in 104 patients with type 1 or 2 diabetes previously treated with MDI and initiating CSII therapy with tubed insulin pumps compared with 109 patients previously treated with MDI continuing MDI. Results After 8 years, the glycaemic control including glycated haemoglobin (HbA1c ), fasting plasma glucose (FPG), and prandial plasma glucose (PPG) improved with both CSII and MDI compared with baseline; however, HbA1c , FPG, and PPG recorded with CSII were lower than data recorded with MDI. During the 8 years, there were fewer CV events with CSII, compared with MDI, and in particular, there were fewer cases of atrial fibrillation, premature ventricular contractions, acute coronary infarction, angina pectoris, heart failure, and peripheral vascular ischemia. We did not record any reduction of ischemic stroke events. Conclusion Our preliminary data suggest that CSII treatment seems to reduce the rates of CV compared with MDI therapy. Moreover, CSII also improved glycaemic control, without increasing the number of hypoglycaemia. However, given the observational design of this trial, our data should be validated in a randomized clinical trial; if they will be confirmed, CSII could be chosen for fully informed and motivated patients at higher risk of developing CV.
- Subjects :
- Blood Glucose
Male
Endocrinology, Diabetes and Metabolism
medicine.medical_treatment
030204 cardiovascular system & hematology
law.invention
Angina
0302 clinical medicine
Endocrinology
Randomized controlled trial
law
Metabolic Syndrome
multiple daily injection
integumentary system
continuous subcutaneous insulin infusion
Incidence
Atrial fibrillation
Middle Aged
Prognosis
cardiovascular event
Italy
Cardiovascular Diseases
Cardiology
Female
Adult
Insulin pump
medicine.medical_specialty
Injections, Subcutaneous
030209 endocrinology & metabolism
03 medical and health sciences
Insulin Infusion Systems
Diabetes mellitus
Internal medicine
Glucose Intolerance
Internal Medicine
medicine
Humans
Hypoglycemic Agents
Retrospective Studies
Glycated Hemoglobin
Inflammation
business.industry
Insulin
medicine.disease
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Heart failure
Metabolic control analysis
business
Biomarkers
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....b59d859cf854cea635ec47dc72960d7a