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Endocrine Abstracts (2015) 37 EP512 | DOI: 10.1530/endoabs.37.EP512

Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de Coimbra, EPE, Coimbra, Portugal.

Introduction: Continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) are forms of intensified insulin therapy and the most used regimens for type 1 diabetes (T1D). Owing to its continuous basal output, hypoglycaemic events tend to be rarer with CSII. Our goal was to evaluate the differences in nocturnal hypoglycemia between these two treatment strategies.

Methods: Retrospective analysis of 61 patients who had performed continuous glucose monitoring (Ipro2, Medtronic, Northridge, CA, USA). All patients had T1D and were either on CSII or MDI. Hypoglycaemia was defined as glucose level <70 mg/dl. Daytime (DT) was defined as the period from 0700 to 2300 h and nighttime (NT) was from 2300 to 0700 h.

Results: We obtained 112 714 glucose measurements (42 132 on CSII and 70 582 on MDI). Our sample had mean age of 31.7±8.8 years, BMI of 22.7±7.5 kg/m2 and a mean glucose of 156±73 mg/dl. Those on CSII were older (33.0 years vs 31.2 years, P<0.05), heavier (25.7 kg/m2 vs 20.8 kg/m2, P<0.05), had a more prolonged duration of T1D (19.4 years vs 16.4 years, P<0.05) and a higher mean glucose measurement (162 mg/dl vs 154 mg/dl, P<0.05) than those on MDI. Hypoglycaemia was more frequent in the MDI group (7410 vs 2608 measurements, P<0.05) and mean HbA1c was similar (7.9 vs 8.0, P>0.05). Hypoglycaemia was more frequent in the MDI group, especially during NT (P<0.05 for both).

Conclusion: Despite similar HbA1c in the two groups, hypoglyacemia is more frequent in the MDI group, particularly at NT period.

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