title: Effects of a novel short-term continuous subcutaneous insulin infusion program evaluated by continuous glucose monitoring on young adult type 1 diabetic patients in Taiwan.
abstract: The aim of this study is to evaluate the effectiveness of blood sugar control by a short-course reinforcement program, consisting of using continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) for young adult type 1 diabetic patients.  Twenty-six pump-naïve type 1 diabetic patients were successively enrolled in two years.  The mean disease duration was 13 years and the mean HbA1c was 8.8 %.  Initially, a 3-day course of CGM was used to evaluate the baseline glycemic status of the subjects, followed by 6-day intensive insulin adjustment by CSII therapy.  Thereafter, a second course of CGM was performed to evaluate the effectiveness of our outcomes in comparison to the initial measurements.  All participants received necessary education and instruction as required throughout the course of the program.  The glucose variability as measured by standard deviation of plasma glucose and mean amplitude of glucose excursion decreased significantly (67.8 ± 2.7 to 52.0 ± 1.8 mg/dL and 140.4 ± 6.5 to 105.5 ± 5.3 mg/dL, p < 0.001).  The hypoglycemic events noted per patient were reduced by 46.4% (p = 0.003) and occurred significantly less often during nocturnal periods (-63.2%, p = 0.002).  Following the adjustment, the mean daily insulin requirement was reduced by 28.05% (from 0.82 to 0.59 IU/kg) and the new proportion of 40% as basal insulin was found.  The short-term CSII program provided significant improvement in blood sugar control for type 1 diabetic patients, by reducing hypoglycemic events, glucose excursion, and insulin dosage in our examined subjects.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Chung-Huei
authors.initials: CH
authors.lastname: Huang
authors.forename: Jir-Shiong
authors.initials: JS
authors.lastname: Tsai
authors.forename: Sheng-Hwu
authors.initials: SH
authors.lastname: Hsieh
authors.forename: Jui-Hung
authors.initials: JH
authors.lastname: Sun
authors.forename: Bie-Yui
authors.initials: BY
authors.lastname: Huang
authors.forename: Miau-Ju
authors.initials: MJ
authors.lastname: Huang
authors.forename: Yu-Yao
authors.initials: YY
authors.lastname: Huang
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; 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* / Q000031:analogs & derivatives / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D018670:Monitoring, Ambulatory; D010353:Patient Education as Topic; D012054:Reinforcement, Psychology; D013624:Taiwan
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human