Diabetes Care, Vol 7, Issue 2 107-113, Copyright © 1984 by American Diabetes Association
Intensified insulin therapy in the type I diabetic adolescent: a controlled trial
AD Schiffrin, M Desrosiers, H Aleyassine and MM Belmonte
The effects of continuous subcutaneous insulin infusion (CSII), intensified
conventional therapy (ICT), and a combination of CSII and ICT (CSII-ICT) on
metabolic control were compared in a group of twenty type I diabetic
adolescents who had previously failed to respond to twice-daily injections
and home glucose monitoring. A marked improvement in control was observed
when mean glycemia and glycosylated hemoglobin A1 (HbA1) were compared with
conventional therapy (CT). In the course of CSII, a lower HbA1 (P less than
0.05) and mean capillary blood glucose (CBG) (P less than 0.04) were
observed than during ICT and CSII-ICT. Acceptability of CSII was greater
than that of ICT and CSII-ICT, with 50% of the patients opting for this
therapy at the end of the 1-yr trial. The marked improvement of control
observed under CSII for the group as a whole was maintained after 6 mo of
completion of the study. Thus, it appears that in type I diabetic
adolescents CSII is more effective and acceptable than ICT and CSII-ICT.