Methods for insulin delivery and glucose monitoring: comparative effectiveness

Golden SH, Brown T, Yeh HC, Maruthur N, Ranasinghe P, Berger Z, Suh Y, Wilson LM, Haberl EB, Bass EB
Record ID 32012000608
English
Authors' objectives: To systematically review whether the mode of intensive insulin therapy (continuous subcutaneous insulin infusion [CSII] vs. multiple daily injections [MDI]) and/or the mode of blood glucose monitoring (real time-continuous glucose monitoring [rt-CGM] vs. selfmonitoring of blood glucose [SMBG]) results in better glycemic control, less hypoglycemia, improved quality of life, and improved clinical outcomes in individuals with type 1 diabetes, type 2 diabetes, and pre-existing diabetes in pregnancy.
Authors' recommendations: The approach to intensive insulin therapy can be individualized to patient preference that will maximize their quality of life, as both CSII and MDI have similar effectiveness on glycemic control and severe hypoglycemia, except in adults with type 1 diabetes where CSII had a favorable effect on HbA1c. These data also indicate that rt-CGM is superior to SMBG in lowering HbA1c, without affecting the risk of severe hypoglycemia, in nonpregnant vi individuals with type 1 diabetes, particularly when compliance is high. Sensor-augmented pumps are superior to MDI/SMBG in lowering HbA1c.
Details
Project Status: Completed
Year Published: 2012
URL for published report: http://effectivehealthcare.ahrq.gov/ehc/products/242/749/CER57_Insulin-Delivery_FinalReport_20120703.pdf
URL for additional information: http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=749
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Blood Glucose
  • Insulin
  • Insulin Infusion Systems
  • Injections
  • Self Care
Contact
Organisation Name: Agency for Healthcare Research and Quality
Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name: martin.erlichman@ahrq.hhs.gov
Contact Email: martin.erlichman@ahrq.hhs.gov
Copyright: Agency for Healthcare Research and Quality (AHRQ)
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