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Updated: Sep 14, 2025

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Factors influencing insulin requirements in using continuous subcutaneous insulin infusion or multiple daily
Ruo-Man Sun1, De-Xing Dai1, Feng Xu1
1National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Disease, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China.
Background:
Studies have shown that patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion (CSII) require a lower dose of insulin than those treated with multiple daily injections (MDIs). However, it is unclear whether this is also the case for patients with type 2 diabetes mellitus (T2DM).
Aim:
To compare insulin dosage requirements between CSII and MDI in T2DM, identifying influencing factors associated with both therapeutic modalities.
Methods:
A total of 954 patients with T2DM were divided into two groups: CSII and MDI groups. The total daily insulin dose (TDD), TDD per kilogram per day (TDD/kg), and ratio of total basal insulin dose to TDD (%TBa) required to achieve the target blood glucose levels were compared between the two groups. In addition, factors affecting insulin dosage were analyzed in both groups of patients.
Results:
Compared to the CSII group, the MDI group required a higher TDD [median (interquartile)]: 30.00 (24.00, 38.00) U/day vs 26.40 (21.60, 32.40) U/day; P < 0.01, TDD/kg and %TBa. In the MDI group and CSII groups, an increase in TDD was independently associated with an increase in body mass index (BMI), waist circumference (WC), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c).
Conclusion:
Patients with T2DM receiving CSII treatment require a lower dose of insulin to achieve good glycemic control. BMI, WC, FPG, and HbA1c are the main factors affecting insulin dosage.
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