The Impact of Insulin Pump Therapy on Glycemic Profiles in Patients with Type 2 Diabetes: Data from the OpT2mise Study

Ignacio Conget, Javier Castaneda, Goran Petrovski, Bruno Guerci, Anne Sophie Racault, Yves Reznik, Ohad Cohen, Sarah Runzis, Simona De Portu, Ronnie Aronson, G. Petrovski, Y. Reznik, G. Kocsis, N. Lalic, H. Tildesley, O. Cohen, B. A. Priestman, M. Metzger, Carol Joyce, G. PodgorskiR. Conway, R. Aronson, B. Perkins, A. Kooy, A. Liebl, B. Guerci, B. Bode, E. Nardacci, A. Buchs, I. Harmann-Boehm, S. Ross, S. Filetti, J. F. Yale, I. Conget, M. Giménez, L. Distiller, R. S. Weinstock, J. Zinger, R. Prager, O. Mosinzon, L. Rose, F. Giorgino, R. Alwani, L. Lieverse, G. B. Bolli, F. Moreau, H. Hanaire

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The OpT2mise randomized trial was designed to compare the effects of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI) on glucose profiles in patients with type 2 diabetes. Research Design and Methods: Patients with glycated hemoglobin (HbA1c) levels of ≥8% (64 mmol/mol) and ≤12% (108 mmol/mol) despite insulin doses of 0.7-1.8 U/kg/day via MDI were randomized to CSII (n=168) or continued MDI (n=163). Changes in glucose profiles were evaluated using continuous glucose monitoring data collected over 6-day periods before and 6 months after randomization. Results: After 6 months, reductions in HbA1c levels were significantly greater with CSII (-1.1±1.2% [-12.0±13.1 mmol/mol]) than with MDI (-0.4±1.1% [-4.4±12.0 mmol/mol]) (P<0.001). Similarly, compared with patients receiving MDI, those receiving CSII showed significantly greater reductions in 24-h mean sensor glucose (SG) (treatment difference, -17.1 mg/dL; P=0.0023), less exposure to SG >180 mg/dL (-12.4%; P=0.0004) and SG >250 mg/dL (-5.5%; P=0.0153), and more time in the SG range of 70-180 mg/dL (12.3%; P=0.0002), with no differences in exposure to SG<70 mg/dL or in glucose variability. Changes in postprandial (4-h) glucose area under the curve >180 mg/dL were significantly greater with CSII than with MDI after breakfast (-775.9±1,441.2 mg/dL/min vs. -160.7±1,074.1 mg/dL/min; P=0.0015) and after dinner (-731.4±1,580.7 mg/dL/min vs. -71.1±1,083.5 mg/dL/min; P=0.0014). Conclusions: In patients with suboptimally controlled type 2 diabetes, CSII significantly improves selected glucometrics, compared with MDI, without increasing the risk of hypoglycemia.

Original languageEnglish
Pages (from-to)22-28
Number of pages7
JournalDiabetes Technology and Therapeutics
Volume18
Issue number1
DOIs
StatePublished - Jan 2016
Externally publishedYes

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