Multicentre randomized controlled trial with sensor-augmented pump vs multiple daily injections in hospitalized patients with type 2 diabetes in China: Time to reach target glucose - 22/02/17

Doi : 10.1016/j.diabet.2016.12.009

W. Gu ^a,^{^{1
These authors contributed equally to this study.},}^{^{2
Tel.: +86 13510549417.}} , Y. Liu ^b,^{^{1
These authors contributed equally to this study.},}^{^{3
Tel.: +86 13514478302.}} , Y. Chen ^c,^{^{4
Tel.: +86 13611143106.}} , W. Deng ^d,^{^{5
Tel.: +86 13911673075.}} , X. Ran ^e,^{^{6
Tel.: +86 13805150781.}} , L. Chen ^f,^{^{7
Tel.: +86 13907130286.}} , D. Zhu ^g,^{^{6
Tel.: +86 13805150781.}} , J. Yang ^h,^{^{5
Tel.: +86 13911673075.}} , J. Shin ^i,^{^{8
Tel.: +1 818 576 4019.}} , S.W. Lee ^i,^{^{9
Tel.: +1 818 576 4204.}} , T.L. Cordero ^i,^{^{10
Tel.: +1 818 576 4423.}} , Y. Mu ^a,^⁎
^a Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, China
^b The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, Jilin Province, China
^c Fu Wai Hospital CAMS & PUMC, 167 Beilishi Road, Xi Cheng District, Beijing, China
^d Beijing Jishuitan Hospital, No. 31, Xin Jie Kou Eastern Street, Western District, Beijing, China
^e West China Hospital-Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan Province, China
^f Union Hospital Tongji Medical College, No. 1277, Jiefang Avenue, Wuhan, Hubei Province, China
^g Nanjing Drum Tower Hospital, Nanjing University Medical School, No. 321, Zhongshan, Nanjing, China
^h Beijing Tongren Hospital, Capital Medical University, No. 1, Dong Jiao Min Xiang, Eastern District, Beijing, China
ⁱ Medtronic, 18000 Devonshire Street, Northridge, CA 91325, United States

^⁎Corresponding author. Tel.: +86 10 5549 9001.

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 22 February 2017
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Abstract

Aim

Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM).

Methods

Adults (aged 18–65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day.

Results

When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P<0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P<0.05] and significantly less hyperglycaemia [sensor glucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P<0.05].

Conclusion

SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.

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Keywords : Continuous glucose monitoring, Hospitalized, Multiple daily injections, Sensor-augmented pump, Short-term intensive insulin, Type 2 diabetes