What is the role of continuous subcutaneous insulin infusion (CSII) in the treatment of type 1 diabetes mellitus (DM)?

Updated: Jul 28, 2020
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

The CSII method provides better control than the MDI method does. Initially, hypoglycemia is common with pump therapy, but once metabolic control is achieved, the risk is the same as with MDI. Bergenstal et al determined that sensor-augmented pump therapy led to better glycemic control and that more patients reached targets with this technology than with injection therapy. [131]

An Australian observational case-control study involving 690 children with type 1 diabetes found that CSII, in comparison with insulin injection therapy, yielded a long-term improvement in glycemic control, as well as a reduction in complications such as severe hypoglycemia and hospitalization for diabetic ketoacidosis (DKA). [132, 133] HbA1c improvement remained significant in the pump therapy cohort throughout 7 years of follow-up.


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