passages: 2125
passages: document
passages: Insulin pump therapy started at the time of diagnosis : effects on glycemic control and pancreatic β-cell function in type 1 diabetes . BACKGROUND In the interest of preserving residual insulin secretory capacity present at the time of diagnosis with type 1 diabetes ( T1D ) , we compared the efficacy of starting insulin pump therapy at diagnosis with standard multiple daily insulin injections ( MDIs ) . METHODS We conducted a prospective , randomized , pilot trial comparing MDI therapy with continuous subcutaneous insulin therapy ( pump therapy ) in 24 patients , 8-18 years old , with newly diagnosed T1D . Subjects were evaluated at enrollment and 1 , 3 , 6 , 9 , and 12 months after initial diagnosis of T1D . Preservation of insulin secretion , measured by mixed-meal-stimulated C-peptide secretion , was compared after 6 and 12 months of treatment . Between-group differences in glycosylated hemoglobin ( HbA1c ) , continuous glucose sensor data , insulin utilization , anthropometric measures , and patient satisfaction with therapy were also compared at multiple time points . RESULTS Initiation of pump therapy within 1 month of diagnosis resulted in consistently higher mixed-meal tolerance test-stimulated C-peptide values at all time points , although these differences were not statistically significant . Nonetheless , improved glycemic control was observed in insulin pump-treated subjects ( more time spent with normoglycemia , better mean HbA1c ) , and pump-treated subjects reported comparatively greater satisfaction with route of treatment administration . CONCLUSIONS Initiation of insulin pump therapy at diagnosis improved glycemic control , was well tolerated , and contributed to improved patient satisfaction with treatment . This study also suggests that earlier use of pump therapy might help to preserve residual β-cell function , although a larger clinical trial would be required to confirm this .
entities: 2126
entities: Intervention_Pharmacological
entities: Insulin pump
entities: 2127
entities: Intervention_Pharmacological
entities: insulin therapy ( pump therapy )
entities: 2128
entities: Intervention_Pharmacological
entities: insulin pump therapy
entities: 2129
entities: Outcome_Physical
entities: glycemic control
entities: 2130
entities: Outcome_Physical
entities: pancreatic β-cell function
entities: 2131
entities: Outcome_Physical
entities: Preservation of insulin secretion
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entities: Outcome_Physical
entities: by mixed-meal-stimulated C-peptide secretion
entities: 2133
entities: Outcome_Physical
entities: glycosylated hemoglobin ( HbA1c ) , continuous glucose sensor data ,
entities: 2134
entities: Outcome_Other
entities: insulin utilization
entities: 2135
entities: Outcome_Physical
entities: , anthropometric measures , and
entities: 2136
entities: Outcome_Other
entities: patient satisfaction
entities: 2137
entities: Outcome_Physical
entities: mixed-meal tolerance
entities: 2138
entities: Outcome_Physical
entities: C-peptide values
entities: 2139
entities: Outcome_Physical
entities: glycemic control
entities: 2140
entities: Outcome_Physical
entities: glycemic control
entities: 2141
entities: Participant_Condition
entities: type 1 diabetes
entities: 2142
entities: Participant_Condition
entities: type 1 diabetes ( T1D )
entities: 2143
entities: Participant_Sample-size
entities: 24
entities: 2144
entities: Participant_Age
entities: 8-18 years old
entities: 2145
entities: Participant_Condition
entities: newly diagnosed T1D