title: Report of a 7 year case-control study of continuous intraperitoneal insulin infusion and subcutaneous insulin therapy among patients with poorly controlled type 1 diabetes mellitus: favourable effects on hypoglycaemic episodes.
abstract: OBJECTIVE
  Continuous intraperitoneal insulin infusion (CIPII) is a last-resort treatment option for patients with type 1 diabetes mellitus (T1DM) who fail to reach adequate glycaemic control with subcutaneous (SC) insulin therapy. Aim was to compare the long-term effects of CIPII and SC insulin therapy among patients with T1DM in poor glycaemic control.
  
  
  METHODS
  Patients in which CIPII was initiated in 2006 were compared with a control group of T1DM patients who continued SC therapy. Linear mixed models were used to calculate differences between the baseline (2006) and final (2013) measurements within and between groups.
  
  
  RESULTS
  A total of 95 patients of which 21 were using CIPII and 74 using SC insulin were included. Within the CIPII group, the number of hypoglycaemic episodes decreased with -5 (95% CI -8 to -3) per 2 weeks while it remained stable among SC patients. Over time, only the number of hypoglycaemic episodes decreased more with CIPII as compared to SC insulin treatment (difference: -6 (95% CI -9 to -4)). There were no differences between treatment groups regarding clinical parameters and quality of life scores over time. Pump or catheter dysfunction led to ketoacidosis in 6 patients: 2 using CIPII and 4 SC insulin.
  
  
  CONCLUSIONS
  After 7 years of follow-up, there is a persistent decline of hypoglycaemic events among CIPII treated T1DM patients. Besides less hypoglycaemic episodes with CIPII therapy, there are no differences between long-term CIPII and SC insulin therapy.
authors.affiliation: Isala, Diabetes Centre, Zwolle, The Netherlands. Electronic address: p.r.van.dijk@isala.nl.
authors.forename: P R
authors.initials: PR
authors.lastname: van Dijk
authors.affiliation: Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands.
authors.forename: S J J
authors.initials: SJ
authors.lastname: Logtenberg
authors.affiliation: Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Department of General Practice, Groningen, The Netherlands.
authors.forename: K H
authors.initials: KH
authors.lastname: Groenier
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands.
authors.forename: R O B
authors.initials: RO
authors.lastname: Gans
authors.affiliation: Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands; Isala, Department of Internal Medicine, Zwolle, The Netherlands.
authors.forename: H J G
authors.initials: HJ
authors.lastname: Bilo
authors.affiliation: Isala, Diabetes Centre, Zwolle, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Internal Medicine, Groningen, The Netherlands; Langerhans Medical Research Group, Zwolle, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Kleefstra
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D016022:Case-Control Studies; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000453:epidemiology; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007263:Infusions, Parenteral; D007328:Insulin / Q000008:administration & dosage* / Q000009:adverse effects; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Continuous intraperitoneal insulin infusion; Glycaemic regulation; Health related quality of life; Hypoglycaemia; Subcutaneous insulin; Type 1 diabetes mellitus