title: The role of continuous subcutaneous insulin infusion therapy in patients with diabetic gastroparesis.
abstract: OBJECTIVE
  To describe the effectiveness of continuous subcutaneous insulin infusion (CSII) in patients with symptomatic diabetic gastroparesis and unstable glycaemic control.
  
  
  METHODS
  Data from 26 patients with symptomatic diabetic gastroparesis and unstable glycaemic control using multiple-dose insulin (MDI) regimens, and subsequently managed with CSII, were analysed.
  
  
  RESULTS
  Following initiation of CSII, the median length of inpatient bed days associated with hospital admissions related to gastroparesis and glycaemic instability was reduced from 8.5 (range 0-144) days patient( -1) year( -1) prior to CSII to 0 (range 0-15) days patient( -1) year( -1). The median HbA(1c) reduction with CSII was 1.8% (22 mmol/mol; p < 0.05). The median capillary blood glucose (CBG) with CSII was significantly lower than with MDI: 7.7 mmol/l (range 3.8-15.4 mmol/l) vs 9.8 mmol/l (range 2.3-27 mmol/l), respectively, p < 0.001. Glycaemic variability with CSII was significantly reduced compared with MDI: CBG CV 0.37 vs CV 0.53, respectively, p < 0.001.
  
  
  CONCLUSIONS
  CSII therapy in patients with diabetic gastroparesis results in significant improvement in glycaemic control and reductions in glycaemic variability and number of hospital inpatient bed days.
authors.affiliation: The Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK. dushyant.sharma@rlbuht.nhs.uk
authors.forename: D
authors.initials: D
authors.lastname: Sharma
authors.forename: G
authors.initials: G
authors.lastname: Morrison
authors.forename: F
authors.initials: F
authors.lastname: Joseph
authors.forename: T S
authors.initials: TS
authors.lastname: Purewal
authors.forename: P J
authors.initials: PJ
authors.lastname: Weston
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D018589:Gastroparesis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology* / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D007902:Length of Stay; D008297:Male; D008422:Materials Testing; D008875:Middle Aged; D055815:Young Adult
chemical_list: D005765:Gastrointestinal Agents; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human