Intensified insulin therapy in the type I diabetic adolescent: a controlled trial.
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.
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002196:Capillaries; D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004435:Eating; D005069:Evaluation Studies as Topic; D006442:Glycated Hemoglobin / Q000032:analysis; D006699:Home Care Services; D006801:Humans; D007332:Insulin Infusion Systems; D008722:Methods; D011897:Random Allocation; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin