Changes in inflammatory markers and efficacy analysis of continuous subcutaneous insulin infusion in senior patients with type 2 diabetes mellitus hospitalized with community-acquired pneumonia: a randomized controlled trial

Eur Geriatr Med. 2024 Apr;15(2):519-525. doi: 10.1007/s41999-023-00915-6. Epub 2024 Jan 9.

Abstract

Objective: The purpose of this study is to analyze the changes in inflammatory markers and efficacy in the treatment of senior patients with type 2 diabetes mellitus (T2DM) and community-acquired pneumonia with continuous subcutaneous insulin infusion (CSII).

Methods: A total of 105 senior patients with T2DM and community-acquired pneumonia, were randomly divided into two groups, viz., treatment group and control group-52 patients in the treatment group were treated with CSII, and 53 patients in the control group with multiple daily insulin injections (MDI). The changes in fasting blood glucose, postprandial blood glucose, total number of white blood cells, neutrophils, percentage of neutrophils, lymphocytes, percentage of lymphocytes, C-reactive protein, serum amyloid A, procalcitonin, interleukin-6 indexes, and the improvement in clinical outcome between the two groups were compared on the 5th and the 10th day of treatment.

Results: In the treatment group, there were 52 patients with an average age of (73.7 ± 8.5) years, which included 28 males and 24 females. In the control group, there were 53 patients, with 27 males and 26 females, with an average age of (74.8 ± 8.8) years. On the 5th and the 10th day of the treatment, the fasting blood glucose, postprandial blood glucose, total number of white blood cells, neutrophils, percentage of neutrophils, lymphocytes, percentage of lymphocytes, C-reactive protein, serum amyloid A, procalcitonin and interleukin-6 of the treatment group were better than that of the control group (P < 0.05). The use of CSII was associated with a higher probability of a prompt recovery (P < 0.05).

Conclusion: The administration of CSII in the treatment of senior patients with T2DM and community-acquired pneumonia can effectively control fasting and postprandial blood glucose, significantly reduce the levels of inflammatory markers, and improve infection treatment efficacy.

Keywords: C-reactive protein; inflammatory markers; Community-acquired pneumonia; Continuous subcutaneous insulin infusion; Type 2 diabetes mellitus.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • C-Reactive Protein / therapeutic use
  • Community-Acquired Infections* / chemically induced
  • Community-Acquired Infections* / drug therapy
  • Diabetes Mellitus, Type 1* / chemically induced
  • Diabetes Mellitus, Type 1* / drug therapy
  • Diabetes Mellitus, Type 2* / chemically induced
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / drug therapy
  • Female
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Injections, Subcutaneous
  • Insulin / adverse effects
  • Insulin / therapeutic use
  • Insulin Infusion Systems
  • Interleukin-6
  • Male
  • Pneumonia* / chemically induced
  • Pneumonia* / drug therapy
  • Procalcitonin / therapeutic use
  • Serum Amyloid A Protein / therapeutic use

Substances

  • Hypoglycemic Agents
  • Blood Glucose
  • C-Reactive Protein
  • Interleukin-6
  • Procalcitonin
  • Serum Amyloid A Protein
  • Insulin