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CSII vs Multiple Daily Injections
Reduction in Severe Hypoglycemia
After 1 year of treatment, both multiple daily injection therapy with glargine plus lispro and CSII with lispro were associated with significantly fewer episodes of severe hypoglycemia than multiple daily injection therapy with lispro and NPH insulin
Reductions in severe hypoglycemia were not significantly different between the CSII and glargine groups
The study of CSII with lispro versus multiple daily injection treatment with glargine plus lispro also evaluated the effects of these treatments on severe hypoglycemia. Both groups experienced a significant decrease in severe hypoglycemic episodes. Among patients assigned to CSII (n=16), there were 0.12 episodes per patient-year compared with 0.37 per patient-year on NPH (P<0.05). In the glargine group (n=16), 0.18 episodes per patient-year occurred versus 0.43 per patient-year with NPH (P<0.05).1
The difference in incidence of severe hypoglycemia was not significant between the CSII and glargine groups. The investigators suggested that the lower variability in insulin absorption associated with CSII and the flat pharmacokinetic profile of glargine accounted for the reduction in severe hypoglycemia in both groups.1
Lepore G, Dodesini AR, Nosari I, Trevisan R. Both continuous subcutaneous insulin infusion and a multiple daily insulin injection regimen with glargine as basal insulin are equally better than traditional multiple daily injection treatment. Diabetes Care. 2003;26:1321-1322.