TY - JOUR
T1 - Insulin/weight ratio may serve as a predictor of success during insulin pump therapy in type 2 diabetes patients
T2 - A proof-of-concept study
AU - Levit, S.
AU - Philippov, Y. I.
AU - Cohen, O.
AU - Weichman, M.
AU - Azuri, J.
AU - Manisteski, Y.
AU - Levit, V.
N1 - Publisher Copyright:
© 2015.
PY - 2015
Y1 - 2015
N2 - Aims: To evaluate long-term efficacy of CSII for treating type 2 diabetes patients. To make an attempt to predict which patient would be more likely to reduce HbA1c levels (success) on CSII. Methods: 18 Type 2 diabetes patients who began insulin pump therapy in our institute were included. All patients were previously treated by insulin with a mean duration of 54.9±51.4 months. Results: Mean duration of follow-up with CSII was 42.2±27.0 months. No significant changes were seen in HbA1c in total cohort (p=0.064), but fasting plasma glucose was reduced from 10,5±2,9 to 7,6±1,9 mmol/l, p=0.007. No weight gain and no severe hypoglycemia were noted. All patients were divided to three groups according to their HbA1c levels: those whose treatment was successful (A), failed (B) or neutral (C), (5, 8, 5 patients respectively). A difference was found in insulin/weight (IWR) ratio within the group A: 0.81±0.29 U/kg before vs. 0.41 ±0.12 U/kg on CSII, p=0.043. There was a difference in IWR on CSII in group A compared to group B (0.41 ±0.12 U/kg vs. 0.93±0.6 U/kg respectively, p=0.011). We also noted a trend of weight reduction in the group A vs. weight gain in the group B. Conclusions: CSII is a viable tool in insulin - requiring type 2 diabetes persons, since the insulin dosing and release it provides are much more physiological. CSII is safe and effective for improving glycemic control, but not in all diabetes patients. We suggest IWR reduction may serve as an early predictor of success on CSII. This work may serve as a "proof-of-concept" study, demonstrating once again the fundamental role of strict weight control in type 2 diabetes. More studies are needed to explore and confirm our experience.
AB - Aims: To evaluate long-term efficacy of CSII for treating type 2 diabetes patients. To make an attempt to predict which patient would be more likely to reduce HbA1c levels (success) on CSII. Methods: 18 Type 2 diabetes patients who began insulin pump therapy in our institute were included. All patients were previously treated by insulin with a mean duration of 54.9±51.4 months. Results: Mean duration of follow-up with CSII was 42.2±27.0 months. No significant changes were seen in HbA1c in total cohort (p=0.064), but fasting plasma glucose was reduced from 10,5±2,9 to 7,6±1,9 mmol/l, p=0.007. No weight gain and no severe hypoglycemia were noted. All patients were divided to three groups according to their HbA1c levels: those whose treatment was successful (A), failed (B) or neutral (C), (5, 8, 5 patients respectively). A difference was found in insulin/weight (IWR) ratio within the group A: 0.81±0.29 U/kg before vs. 0.41 ±0.12 U/kg on CSII, p=0.043. There was a difference in IWR on CSII in group A compared to group B (0.41 ±0.12 U/kg vs. 0.93±0.6 U/kg respectively, p=0.011). We also noted a trend of weight reduction in the group A vs. weight gain in the group B. Conclusions: CSII is a viable tool in insulin - requiring type 2 diabetes persons, since the insulin dosing and release it provides are much more physiological. CSII is safe and effective for improving glycemic control, but not in all diabetes patients. We suggest IWR reduction may serve as an early predictor of success on CSII. This work may serve as a "proof-of-concept" study, demonstrating once again the fundamental role of strict weight control in type 2 diabetes. More studies are needed to explore and confirm our experience.
KW - Concept
KW - Insulin
KW - Obese
KW - Pump
KW - Type 2 diabetes
KW - Weight
UR - http://www.scopus.com/inward/record.url?scp=84929623749&partnerID=8YFLogxK
U2 - 10.14341/DM2015170-77
DO - 10.14341/DM2015170-77
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AN - SCOPUS:84929623749
SN - 2072-0351
VL - 18
SP - 70
EP - 77
JO - Diabetes Mellitus
JF - Diabetes Mellitus
IS - 1
ER -