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Continuous subcutaneous insulin infusion (CSII) versus multiple insulin injections for type 1 diabetes mellitus

Marie L Misso1, Kristine J Egberts, Matthew Page

  • 1Australasian Cochrane Centre, Monash Institute of Health Services Research, Monash University, 43-51 Kanooka Grove, Clayton, Victoria, Australia, 3168.

The Cochrane Database of Systematic Reviews
|January 22, 2010
PubMed

Insights

Continuous subcutaneous insulin infusion (CSII) may improve glycaemic control in type 1 diabetes compared to multiple insulin injections (MI). While severe hypoglycemia may be reduced with CSII, evidence on adverse events remains limited.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Diabetes Management

Background:

  • Type 1 diabetes is an autoimmune metabolic disorder characterized by defective insulin secretion.
  • It is a common chronic disease in childhood and adolescence, requiring effective management strategies.
  • Current treatment involves insulin replacement via multiple daily injections (MI) or continuous subcutaneous insulin infusion (CSII).

Purpose of the Study:

  • To compare the efficacy and safety of CSII versus MI in individuals with type 1 diabetes mellitus.
  • To evaluate effects on glycaemic control, hypoglycaemic events, quality of life, and adverse events.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searches conducted across major electronic databases (Cochrane Library, MEDLINE, EMBASE, CINAHL).
  • Data extraction and risk of bias assessment performed independently by two authors.

Main Results:

  • Twenty-three studies involving 976 participants were analyzed.
  • CSII showed a statistically significant improvement in glycosylated haemoglobin A1c (HbA1c) compared to MI (WMD -0.3%).
  • Severe hypoglycaemia appeared reduced with CSII, and quality of life was generally preferred; no significant differences in weight or non-severe hypoglycaemia were noted.

Conclusions:

  • CSII demonstrates potential benefits for glycaemic control in type 1 diabetes.
  • Evidence suggests CSII may reduce severe hypoglycaemic events and improve quality of life.
  • Further research is needed to clarify risks associated with adverse events, mortality, morbidity, and costs.
Abstract

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