Related Experiment Video

Updated: Jul 11, 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

Basal insulin supplementation in Type 1 diabetic children: a long-term comparative observational study between

R Schiaffini1, P I Patera, C Bizzarri

  • 1Department of Pediatric Medicine Unit of Endocrinology and Diabetology, Bambino Gesù Children's Hospital, IRRCS, 00165 Rome, Italy.

Journal of Endocrinological Investigation
|September 13, 2007
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) demonstrated superior long-term glycemic control compared to multiple daily injections (MDI) with glargine insulin in children and adolescents with Type 1 diabetes (T1D). CSII offers sustained HbA1c reduction over two years.

Area of Science:

  • Pediatric Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Limited long-term data exist comparing glargine insulin efficacy with continuous subcutaneous insulin infusion (CSII) in pediatric Type 1 diabetes (T1D).
  • Optimizing basal insulin delivery is crucial for managing T1D in children and adolescents.
  • Current treatment paradigms often involve multiple daily injections (MDI) or CSII.

Purpose of the Study:

  • To compare the two-year efficacy of glargine insulin via MDI versus CSII in pediatric T1D patients.
  • To evaluate the long-term impact of different basal insulin delivery methods on glycemic control.
  • To inform best practices for basal insulin supplementation in young T1D individuals.

Main Methods:

  • A prospective study involving 36 children and adolescents (9-18 years) with T1D diagnosed at least 3 years prior.
  • Randomized assignment to either MDI with once-daily glargine and mealtime regular insulin or CSII using rapid-acting insulins (aspart or lispro).
  • Assessment of glycosylated hemoglobin (HbA1c), insulin requirements, body mass index (BMI) SD score, and severe hypoglycemia over two years.

Main Results:

  • Both MDI and CSII groups achieved significant HbA1c reduction in the first year.
  • Only the CSII group maintained significant HbA1c reduction into the second year.
  • Overall insulin requirements decreased significantly only in the CSII group during the first year.
  • No significant differences were noted in BMI SD score, severe hypoglycemia, or basal insulin supplementation between groups.

Conclusions:

  • CSII demonstrated superior long-term efficacy in improving glycemic control (HbA1c) compared to MDI with glargine in pediatric T1D patients.
  • CSII may be considered the gold standard for intensive insulin therapy, even for long-term management in this population.
  • Sustained glycemic control benefits favor CSII over MDI with glargine for extended periods in children and adolescents with T1D.

More Related Videos

Improving IV Insulin Administration in a Community Hospital12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Related Concept Videos

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...
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...
Diabetes Mellitus: Overview and Type I Subtype01:22

Diabetes Mellitus: Overview and Type I Subtype

Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
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...
Glucose Homeostasis: Pancreatic Islets and Insulin Secretion01:27

Glucose Homeostasis: Pancreatic Islets and Insulin Secretion

The pancreatic islets comprising only 1%-2% of the volume are highly vascularized and innervated mini-organs. They contain five endocrine cell types, including β cells that secrete insulin, which is synthesized as a single polypeptide chain, preproinsulin, processed to proinsulin, and finally to insulin and C-peptide. This process is complex and regulated, involving the Golgi complex, the endoplasmic reticulum, and the secretory granules of the β cell.
Insulin and C-peptide are co-secreted in...