Hypoglycemia and blood glucose fluctuations in the application of a sensor-augmented insulin pump

Diabetes Technol Ther. 2013 Dec;15(12):984-9. doi: 10.1089/dia.2013.0078. Epub 2013 Sep 4.

Abstract

Background: The purpose of this study was to understand the effect of sensor-augmented insulin pump (SAP) use on hypoglycemia and blood glucose (BG) fluctuations.

Subjects and methods: Sixty patients with type 2 diabetes mellitus were randomly assigned to three groups of treatment with SAP, continuous subcutaneous insulin infusion (CSII), or multiple daily injection (MDI) therapy for 6 days. Parameters of glycemic control that were determined included mean BG concentration (MBG), SD of BG (SDBG), mean amplitude of glycemic excursions (MAGE), absolute means of daily differences (MODD), 24-h area under the curve at 10 h (AUC10), 24-h area under the curve at 3.9 h (AUC3.9), and Low Blood Glucose Index (LBGI).

Results: No significant differences were observed among the three groups in terms of MBG, SDBG, MAGE, or MODD at the beginning of treatment. The MBG, SDBG, MAGE, MODD, and total AUC10 of the SAP group improved over the 4 days of the intervention compared with the CSII and MDI groups; however, no significant differences were observed among the three groups in terms of total AUC3.9 and LBGI.

Conclusions: Compared with CSII and MDI therapy, SAP therapy was able to rapidly lower mean BG and reduce BG level fluctuations with no increased risks of hypoglycemia.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Area Under Curve
  • Biosensing Techniques
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Female
  • Glycated Hemoglobin / drug effects
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / chemically induced
  • Hypoglycemia / prevention & control*
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / adverse effects
  • Infusion Pumps, Implantable*
  • Injections, Subcutaneous
  • Insulin / administration & dosage*
  • Insulin / adverse effects
  • Insulin Infusion Systems*
  • Male
  • Middle Aged
  • Treatment Outcome

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human