Suspension of basal insulin in CSII therapy

Treatment with continuous s.c. insulin infusion (CSII) is reported to provide better glycemic control for patients with type 1 diabetes mellitus than conventional therapy with multiple daily insulin injections. However, achievement of postprandial glycemic control remains one of the most challenging goals in the management of type 1 diabetes patients.

Boronat et al. report on two female patients who began treatment with CSII but had to increase their previous breakfast insulin-to-carbohydrate ratio in order to achieve postprandial glycemic goals. In both cases, the action of insulin boluses was too slow with regard to the requirements of patients, leading to the appearance of late worrisome hypoglycemia.

They conclude that the bioavailability of insulin infused through pumps for CSII does not fit to the needs of some particular patients. Improved algorithms for delivering prandial insulin or the introduction of novel faster insulin molecules could be future alternatives to overcome these drawbacks.

Read full Case Report titled “Suspension of basal insulin to avoid hypoglycemia in type 1 diabetes treated with insulin pump” by Boronat et al. (2015).

DOI: 10.1530/EDM-14-0081