Multicentre randomized controlled trial with sensor-augmented pump vs multiple daily injections in hospitalized patients with type 2 diabetes in China: Time to reach target glucose

• Published in: Diabetes & metabolism Vol. 43; no. 4; pp. 359 - 363
• Main Authors: Gu, W, Liu, Y, Chen, Y, Deng, W, Ran, X, Chen, L, Zhu, D, Yang, J, Shin, J, Lee, S.W, Cordero, T.L, Mu, Y
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-09-2017
• Subjects: Adolescent; Adult; Aged; Blood Glucose; Blood Glucose Self-Monitoring; China; Continuous glucose monitoring; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Drug Administration Schedule; Endocrinology & Metabolism; Female; Hospitalized; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Insulin - administration & dosage; Insulin - therapeutic use; Insulin Infusion Systems; Internal Medicine; Male; Middle Aged; Multiple daily injections; Sensor-augmented pump; Short-term intensive insulin; Type 2 diabetes; Young Adult; Continuous glucose monitoring; Short-term intensive insulin; Type 2 diabetes; Hospitalized; Multiple daily injections; Sensor-augmented pump
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2016.12.009

Abstract Aim Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods Adults (aged 18–65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130 mg/dL (4.4 and 7.2 mmol/L) and three 2-h postprandial measurements between 80 and 180 mg/dL (4.4 and 10.0 mmol/L) within the same day. Results When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7 ± 1.1 vs 6.3 ± 3.1 days for MDI; P < 0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose < 50 mg/dL (2.8 mmol/L): 0.04% vs 0.32%, respectively; P < 0.05] and significantly less hyperglycaemia [sensor glucose > 180 mg/dL (10 mmol/L): 21.56% vs 35.03%, respectively; P < 0.05]. Conclusion SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.