Comparison Between Multi-injection and Continuous Subcutaneous Insulin Therapy in Insulin-dependent Diabetic Inpatients

Circadian blood glucose profiles have been evaluated in 8 insulin-dependent diabetic inpatients on their usual home insulin therapy, on a 3-injection regimen (ultralente in the morning plus 3 injections of regular insulin at meals), on continuous subcutaneous insulin infusion by portable micropumps (Mill Hill 1001) and, again, on a 3-injection regimen at the same insulin dose as during continuous subcutaneous insulin infusion. The 3-injection regimen achieved a mean daily blood glucose level comparable to that obtained by continuous subcutaneous insulin infusion, even if significantly more insulin was needed. At comparable insulin doses, continuous subcutaneous insulin infusion provided a significantly lower mean daily blood glucose. Glycemic control at 0600 and 0800 was better during continuous subcutaneous insulin infusion. Low acceptance by the patients of the home use of portable micropumps was evidenced because of the practical and psychological problems involved.