The Application of Continuous Glucose Monitoring with a Fasting Test to Establish a Basal Insulin Infusion Program for Japanese Type 1 Diabetes Mellitus Patients at the Time of Switching from Multiple Daily Injection Therapy to Continuous Subcutaneous Insulin Infusion

Abstract

The efficacy of continuous glucose monitoring (CGM) with a fasting test to establish the basal insulin infusion program in continuous subcutaneous insulin infusion (CSII) was examined in 18 Japanese type 1 diabetes mellitus patients that had been treated with multiple daily injection (MDI). The insulin regimen was switched from MDI to CSII following the data monitoring by CGM including a fasting test during their admission and they were then followed up after six months. The total insulin doses decreased significantly from 44.9±14.3 u/day to 33.7±7.8 u/day just after switching to CSII (p=0.0002). The basal insulin doses decreased significantly from 18.4±7.4 u/day to 12.2±4.5 u/day as well (p=0.0002), and did not change (12.6±4.8 u/day) for six months after switching to CSII. The mean HbA1c also improved significantly from 8.4±1.0 % to 7.7±1.0 % six months after switching to CSII (p=0.0095). In conclusion, the introduction of CSII after the establishment of a basal insulin infusion program based on CGM, particularly the data from a fasting test, was thus found to successfully decrease and sustain better HbA1c levels without an increase in the basal and total insulin doses.