Related Experiment Video

Updated: Aug 23, 2026

Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain
08:32

Studying the Hypothalamic Insulin Signal to Peripheral Glucose Intolerance with a Continuous Drug Infusion System into the Mouse Brain

Published on: January 4, 2018

A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple

Elizabeth A Doyle1, Stuart A Weinzimer, Amy T Steffen

  • 1Department of Pediatrics and Children's Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut, USA. elizabeth.doyle@yale.edu

Diabetes Care
|June 29, 2004
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) significantly improved glycemic control in youth with type 1 diabetes compared to multiple daily injections (MDI) with insulin glargine. CSII therapy led to lower HbA1c and improved blood glucose readings in this pediatric study.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disease Management
  • Diabetes Technology

Background:

  • Efficacy of insulin analogs for type 1 diabetes in pediatric patients using multiple daily injection (MDI) and continuous subcutaneous insulin infusion (CSII) is not fully established.
  • Insulin glargine and insulin aspart are commonly used in MDI and CSII regimens for type 1 diabetes management.

Purpose of the Study:

  • To compare the efficacy of CSII versus MDI with insulin glargine in reducing HbA1c levels in children and adolescents with type 1 diabetes.
  • To evaluate metabolic control parameters, including HbA1c and blood glucose readings, in pediatric patients with type 1 diabetes on different insulin delivery methods.

Main Methods:

  • A 16-week randomized study involving 32 youth (ages 8-21) with type 1 diabetes.
  • Participants were assigned to either MDI (insulin glargine and insulin aspart) or CSII (insulin aspart).
  • Dose titration was guided by self-monitored blood glucose and monthly HbA1c assessments.

Main Results:

  • The CSII group showed a significant reduction in HbA1c from 8.1% to 7.2% (P < 0.02), while the glargine MDI group showed no significant change (8.2% to 8.1%).
  • Total daily insulin dose decreased significantly in the CSII group (1.4 to 0.9 units/kg, P < 0.01), but remained unchanged in the MDI group.
  • CSII resulted in significantly lower lunch, dinner, and bedtime blood glucose readings compared to MDI.

Conclusions:

  • CSII demonstrated superior efficacy in improving glycemic control, achieving lower HbA1c and premeal glucose levels compared to glargine-based MDI in this short-term pediatric study.
  • CSII is an effective treatment option for enhancing metabolic control in youth diagnosed with type 1 diabetes.
Abstract

Related Concept Videos

Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into rapid-acting...
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...
Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations01:15

Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations

Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...