Observations on control of glycemia with XXXX or continuous subcutaneous insulin infusion.

@entity4051 @entity1 @entity7617 @entity413
Determination of glycemic differences between groups treated with continuous subcutaneous insulin infusion (CSII) or @entity7617 ( @entity7617 ) was central to the major objective of the study. Assessment of glycemia was based on 24-h inhospital profiles of plasma @entity413 ; pre- and postprandial and bedtime (seven time points) diurnal profiles performed monthly on outpatient samples; and glycosylated hemoglobin ( @entity4051 ) measured bimonthly at each center. The correlation between plasma @entity413 determinations in the central laboratory and in local laboratories was 0.988. Significance of differences between treatments was by analysis of variance and least-squares regression. At baseline, mean inhospital plasma @entity413 and @entity4051 concentrations and insulin dosages were identical in the groups randomized to CSII or @entity7617 . A prompt decrement of indices of glycemic control during CSII was observed such that mean decrements sustained over the 8-mo treatment period in home and in hospital plasma @entity413 profiles and @entity4051 relative to values obtained during @entity7617 (P less than 0.0001). The likelihood of CSII-treated @entity1 achieving glycemic indices within the normal range was increased. The standardization of the mean and the M-value calculated from inhospital @entity413 profiles during CSII and @entity7617 at 4 and 8 mo indicated that there was less plasma @entity413 fluctuation during CSII. The method of pooling standardized local @entity4051 measurements from the six centers appeared to be an adequate substitute for centrally performed @entity4051 determinations. Advantages of inhospital plasma @entity413 measurements in terms of accuracy and ability to obtain nocturnal samples contrasted with the likelihood of increased realism and superior correlation with @entity4051 in home-obtained samples.(ABSTRACT TRUNCATED AT 250 WORDS)
