Factors influencing insulin requirements in using continuous subcutaneous insulin infusion or multiple daily injections in type 2 diabetes.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-07-15 DOI:10.4239/wjd.v16.i7.106470

Ruo-Man Sun, De-Xing Dai, Feng Xu, Ya-Li Ling, Zhong-Jian Xie

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Abstract

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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2型糖尿病患者持续皮下胰岛素输注或每日多次注射胰岛素需求的影响因素

背景：研究表明，持续皮下胰岛素输注（CSII）治疗的1型糖尿病患者所需的胰岛素剂量低于每日多次注射（mdi）治疗的患者。然而，目前尚不清楚2型糖尿病（T2DM）患者是否也是如此。目的：比较CSII和MDI治疗T2DM的胰岛素剂量需求，确定两种治疗方式的相关影响因素。方法：将954例T2DM患者分为CSII组和MDI组。比较两组患者每日胰岛素总剂量（TDD）、每日每千克胰岛素总剂量（TDD/kg）和达到目标血糖水平所需的基础胰岛素总剂量与胰岛素总剂量之比（%TBa）。分析两组患者胰岛素用量的影响因素。结果：与CSII组相比，MDI组需要更高的TDD[中位数（四分位数）]:30.00 (24.00,38.00)U/天vs 26.40 (21.60, 32.40) U/天；P < 0.01， TDD/kg和%TBa。在MDI组和CSII组中，TDD的增加与体重指数（BMI）、腰围（WC）、空腹血糖（FPG）和糖化血红蛋白（HbA1c）的增加独立相关。结论：接受CSII治疗的T2DM患者需要较低剂量的胰岛素才能达到良好的血糖控制。BMI、WC、FPG、HbA1c是影响胰岛素用量的主要因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.