Related Experiment Video
Updated: Jul 2, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Continuous subcutaneous insulin infusion vs. multiple daily injections in children with type 1 diabetes: a systematic
Ewa Pańkowska1, Marlena Błazik, Piotr Dziechciarz
1The Second Department of Pediatrics, Medical University of Warsaw, Poland. epankowska@interia.pl
Objective:
To investigate potential effects of continuous subcutaneous insulin infusion (CSII) compared with multiple daily injections (MDI) on glycemic control in children with type 1 diabetes mellitus (T1DM).
Study Design:
Meta-analysis and systematic review of randomized control studies (RCTs). The electronic databases MEDLINE, Cochrane Library, and EMBASE were searched through October 2007.
Results:
Six RCTs involving 165 participants with T1DM met our predefined inclusion criteria. Combined data from all trials showed that the CSII group compared with the MDI group experienced a significant reduction in the level of glycosylated hemoglobin. The pooled weighted mean difference (WMD) was -0.24% [95% confidence interval (95% CI) -0.41 to -0.07, p < 0.001] with a fixed model and remained significant in the random effect model. This effect was reached by slightly decreasing insulin requirement [three RCTs, n = 74, WMD -0.22 IU/kg/d (95% CI -0.31 to -0.14, p < 0.001)]. No differences in the incidences of ketoacidosis and severe hypoglycemic events were found.
Conclusions:
In short-term insulin therapy, CSII compared with MDI is a more effective form of metabolic control and allows reducing the daily insulin requirement. Yet, no conclusions have been made so far whether this effect holds in later years. These results should be approached with caution because of the methodological limitations of the analyzed studies.
Related Concept Videos
Insulin: Dosing Regimen and Adverse Effects
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 Delivery
Short-acting insulins are divided into rapid-acting...
Diabetes Mellitus: Overview and Type I Subtype
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...
Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
Drug Dosing: Infants and Children
Parenteral Drug Delivery Systems: Injectables, Implants, and Infusion Devices