title: Factors associated with improved glycemic control following continuous subcutaneous insulin infusion therapy in patients with type 2 diabetes uncontrolled with bolus-basal insulin regimens: An analysis from the OpT2mise randomized trial.
abstract: This analysis investigated factors associated with the decrease in HbA1c in patients receiving continuous subcutaneous insulin infusion (CSII) in the OpT2mise randomized trial. In this study, patients with type 2 diabetes and HbA1c >8% following multiple daily injections (MDI) optimization were randomized to receive CSII (n = 168) or MDI (n = 163) for 6 months. Patient-related and treatment-related factors associated with decreased HbA1c in the CSII arm were identified by univariate and multivariate analyses. CSII produced a significantly greater reduction in HbA1c than MDI, and the treatment difference increased with baseline HbA1c. In the CSII arm, the only factors significantly associated with decreased HbA1c were higher baseline HbA1c (P < .001), geographical region (P < .001), higher educational level (P = .012), higher total cholesterol level (P = .002), lower variability of baseline glucose values on continuous glucose monitoring (P < .001) and the decrease in average fasting self-monitored blood glucose at 6 months (P < .001). These findings suggest that CSII offers an option to improve glycemic control in a broad range of patients with type 2 diabetes in whom control cannot be achieved with MDI. OpT2mise ClinicalTrials.gov number: NCT01182493 (https://clinicaltrials.gov/).
authors.affiliation: Diabetes Clinic, Clalit Health Services, Jerusalem, Israel.
authors.forename: Muriel
authors.initials: M
authors.lastname: Metzger
authors.affiliation: Medtronic Bakken Research Center, Maastricht, The Netherlands.
authors.forename: Javier
authors.initials: J
authors.lastname: Castañeda
authors.affiliation: Department of Endocrinology, University of Caen Côte de Nacre Regional Hospital Center, Caen, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Reznik
authors.affiliation: Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Giorgino
authors.affiliation: Diabetes Unit, Endocrinology and Nutrition Department, University Hospital Clinic, Barcelona, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Conget
authors.affiliation: LMC Diabetes & Endocrinology, Toronto, Ontario, Canada.
authors.forename: Ronnie
authors.initials: R
authors.lastname: Aronson
authors.affiliation: Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
authors.forename: Simona
authors.initials: S
authors.lastname: de Portu
authors.affiliation: Medtronic International Trading Sàrl, Tolochenaz, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Runzis
authors.affiliation: Medtronic Diabetes, Northridge, California.
authors.forename: Scott W
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Ohad
authors.identifier: 0000-0003-4337-1795
authors.initials: O
authors.lastname: Cohen
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage*; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: blood glucose self-monitoring; glycated hemoglobin; insulin infusion systems; insulin therapy; multiple daily injections; type 2 diabetes mellitus