Assessment of Glycemic Variability in Continuous Subcutaneous Insulin Infusion Therapy in Type 1 Diabetes Related to Anthropometry and Complication Status

Abstract

We present an observational study assessing the relationship between glycemic variability (GV) and anthropometry (age, sex, body mass index [BMI]), microvascular complication status, and duration of diabetes in type 1 diabetes mellitus (T1DM) subjects treated with continuous subcutaneous insulin infusion (CSII) or multiple dose injection (MDI) therapy. Intraday GV was measured by standard deviation of glucose, mean amplitude of glycemic excursion (MAGE), M value, and J index, and interday variability was measured by the mean of daily differences (MODD). Thirty-five subjects (19 on MDI and 16 on CSII therapy) were recruited, and the treatment groups were not significantly different. Glucose was monitored for a 48 h period for each subject using a Medtronic Gold continuous glucose monitoring system. Overall glycemia, as measured by mean blood glucose (MBG) and hemoglobin A1c (HbA1c), was significantly lower (1.6 mmol/liter and 0.9%, respectively) in the CSII group than the MDI group (Table 1). Statistically significantly greater GV was found in the MDI group than in the CSII group (Table 1). This finding of lower GV in subjects with T1DM on CSII therapy is significant, as few studies have investigated this previously.1 No significant difference in MBG and the degree of GV was found between males and females on both MDI and CSII therapy. Table 1. Results Comparing Glycemia and Glycemic Variability between Subjects on Multiple Dose Injection and Those on Continuous Subcutaneous Insulin Infusion