CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

July 10th, 2012

Intensive Insulin Therapies Similarly Efficacious in Diabetes

Multiple daily insulin injections and continuous subcutaneous insulin analogue infusion are similarly effective in lowering hemoglobin A1c levels while limiting episodes of severe hypoglycemia in type 2 diabetes, according to a systematic review published in the Annals of Internal Medicine.

The analysis included 33 randomized controlled trials among children and adults with type 1 or type 2 diabetes. Among the other findings:

  • The two intensive therapies also performed similarly well in children with type 1 diabetes; in adults with type 1 diabetes, however, continuous subcutaneous infusion led to greater HbA1c reductions than did multiple daily injections (this latter outcome was heavily influenced by one trial).
  • Real-time continuous blood glucose monitoring, assessed in type 1 diabetes, generally produced better outcomes than self-monitoring of blood glucose with fingersticks.

The authors caution that most of the studies in their analysis were of fair to poor quality — with the largest having 322 participants.

Categories: General


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