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Endocrine Abstracts (2013) 32 P487 | DOI: 10.1530/endoabs.32.P487

Endocrinology Department, Medical Faculty, Dokuz Eylül University, Izmir, Turkey.


Introduction: Continuous s.c. insulin infusion (CSII) therapy is a well documented treatment modality in type 1 diabetes mellitus (DM), but its usage in type 2 DM has not become prevalent so far. It may be a treatment alternative in severely insulin resistant type 2 diabetics recieving high doses of insulin. We present a type 2 diabetic patient that we had to shift from multiple dosage insulin (MDI) injection to CSII therapy due to the widespread echimosis at the insulin injection sites.

Case: Fifty-seven-year-old female patient with type 2 diabetes for 19 years was on insulin therapy for 6 years of the last four being as MDI therapy. She describe decchymosis at insulin injection sites from the onset of insulin therapy. Her hematological tests for coagulopathy were completely normal. Due to the injection site problems her glycemic control could not be achieved (frequent hypoglycemic and hyperglycemic episodes) with MDI after which switch to CSII therapy was done. Her compliance to CSII was well and she didn’t experience large glucose fluctuations during with this therapy anymore. After initiation of CSII, her daily insulin need decreased and HbA1c improved markedly (Table).

Table 1 Table: HbA1c and total dialy insulin need before and after CSII
Pre-CSII Post-CSII (3rd month)Post-CSII (9th month)
HbA1c (%)7.26.46.1
Meandailyinsulin (units/day)5432.432.4

Conclusion: Studies about CSII therapy in type 2 DM have demonstrated that this therapy improves the gycemic control, decreases the insulin need and HbA1c of the patients. In addition less blood glucose fluctuations and better quality of life measures were recorded with this treatment modality. Insulin administration with CSII seems to be an alternative in selected type 2 diabetics as in our case.

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