Objective: Short-term continuous subcutaneous insulin infusion (CSII) has been proved to be efficacy in T2D patients. However, limited evidence is available about the effect of oral anti-diabetic drugs (OADs) added to short-term CSII in T2D. This study is aimed to compare the efficacy of OADs added to CSII with CSII alone on glucose control and glycemic variability (GV) in T2D.

Methods: A total of 206 hospitalized T2D patients who received CSII alone (CSII group, n=78) or CSII plus OADs (+OADs group, n=128) were included. The patient’s glycemic control and GV indices were derived from capillary blood glucose (BG) monitoring seven times a day. The insulin doses and time to achieve target BG (FBG<7mmolL and 2h postprandial BG<10mmol/L) were recorded.

Results: These patients were 52.5±13.0 years old, with diabetes duration of 5.8±5.9 years, and HbA1c of 9.45±2.15%. Compared with those in the CSII group, FBG (-1.39±2.40 mmol/L vs. -0.31±2.05 mmol/L), 2hBG after breakfast (-2.68±5.06 mmol/L vs. -1.16±4.26 mmol/L), 2hBG after lunch (-5.09±5.01 mmol/L vs. -2.76±5.08 mmol/L), 2hBG after supper (-3.32±4.69 mmol/L vs. -1.60±4.58 mmol/L), BG before lunch (-3.63±4.93 mmol/L vs. -2.09±3.37 mmol/L), BG before bedtime (-2.65±4.28 mmol/L vs. -1.38±4.11 mmol/L) after therapy in + OADs group decreased more obviously (all p<0.05). Moreover, +OADs group exhibited lower GV indices (SDBG: 1.89±0.55 mmol/L vs. 2.21±0.79 mmol/L; PPGE: 2.41±0.97 mmol/L vs. 2.79±1.09 mmol/L; LAGE: 5.32±1.62 mmol/L vs. 5.96±1.93 mmol/L; MAGE: 4.14±1.70 mmol/L vs. 5.08±2.81 mmol/L; and CV: 0.24±0.08 vs. 0.27±0.09, respectively) compared to CSII group (all p<0.05). Incidence of hypoglycemia was lower in +OADs group (21.1% VS 37.6%, p<0.05). The insulin doses and time to achieve target BG did not differ between the two groups.

Conclusions: OADs added to short-term CSII could further improve glycemic control and GV indices with lower incidence of hypoglycemia in T2D patients compared with CSII alone.

Disclosure

W. Jiang: None. D. Chen: None. W. Xu: None. L. Zeng: None.

© 2024 by the American Diabetes Association
2024
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