The role of continuous subcutaneous insulin infusion therapy in patients with diabetic gastroparesis

Diabetologia. 2011 Nov;54(11):2768-70. doi: 10.1007/s00125-011-2282-6. Epub 2011 Aug 14.

Abstract

Aims/objective: To describe the effectiveness of continuous subcutaneous insulin infusion (CSII) in patients with symptomatic diabetic gastroparesis and unstable glycaemic control.

Methods: Data from 26 patients with symptomatic diabetic gastroparesis and unstable glycaemic control using multiple-dose insulin (MDI) regimens, and subsequently managed with CSII, were analysed.

Results: Following initiation of CSII, the median length of inpatient bed days associated with hospital admissions related to gastroparesis and glycaemic instability was reduced from 8.5 (range 0-144) days patient( -1) year( -1) prior to CSII to 0 (range 0-15) days patient( -1) year( -1). The median HbA(1c) reduction with CSII was 1.8% (22 mmol/mol; p < 0.05). The median capillary blood glucose (CBG) with CSII was significantly lower than with MDI: 7.7 mmol/l (range 3.8-15.4 mmol/l) vs 9.8 mmol/l (range 2.3-27 mmol/l), respectively, p < 0.001. Glycaemic variability with CSII was significantly reduced compared with MDI: CBG CV 0.37 vs CV 0.53, respectively, p < 0.001.

Conclusions/interpretation: CSII therapy in patients with diabetic gastroparesis results in significant improvement in glycaemic control and reductions in glycaemic variability and number of hospital inpatient bed days.

MeSH terms

  • Adult
  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Female
  • Follow-Up Studies
  • Gastrointestinal Agents / therapeutic use
  • Gastroparesis / complications
  • Gastroparesis / drug therapy
  • Gastroparesis / physiopathology*
  • Gastroparesis / therapy
  • Glycated Hemoglobin / analysis
  • Hospitalization / statistics & numerical data
  • Humans
  • Hyperglycemia / prevention & control*
  • Hypoglycemia / prevention & control*
  • Hypoglycemic Agents / administration & dosage*
  • Hypoglycemic Agents / therapeutic use
  • Infusions, Subcutaneous
  • Insulin / administration & dosage*
  • Insulin / therapeutic use
  • Insulin Infusion Systems*
  • Length of Stay
  • Male
  • Materials Testing
  • Middle Aged
  • Young Adult

Substances

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