Continuous subcutaneous insulin infusion versus multiple daily insulin injections in type 2 diabetes: a meta-analysis.

摘要

BACKGROUND: Continuous Subcutaneous Insulin Infusion (CSII) improves HbA1c in type 1 diabetic patients unsatisfactorily controlled by Multiple Daily Injections (MDI). Few trials have explored CSII for basal-bolus therapy in type 2 diabetes. MATERIALS AND METHODS: Randomized Clinical Trials (RCTs) comparing CSII and MDI for at least 12 weeks in type 2 diabetic patients were retrieved, assessing between-group differences in HbA1c and insulin daily dose at endpoint, and incidence of hypoglycemia. RESULTS: A total of 4 RCTs was included in the analysis. CSII did not produce any significant improvement of HbA1c in comparison with MDI (Standardized difference in mean: 0.09(-0.08;0.26)%; p=0.31). No significant difference was observed in the rate of hypoglycemic episodes. CSII was associated with a nonsignificant trend toward the reduction of insulin doses used at the end of trial. CONCLUSIONS: Available data do not justify the use of CSII for basal-bolus insulin therapy in type 2 diabetes.