ProAct Study: New Features of Insulin Pumps Improve Diabetes Management and Glycemic Control in Patients after Transition of Continuous Subcutaneous Insulin Infusion Systems

Ziegler, Ralph; Tubili, Claudio; Chico, Ana; Guerci, Bruno; Lundberg, Elena; Borchert, Margret; Löffler, Andrea; Bloethner, Sandra; Weissmann, Joerg; Pfützner, Andreas

doi:10.1089/dia.2013.0090

Cited by 25 publications

(26 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our cross-sectional post hoc analysis of baseline data collected from participants of the ProAct study, 7 we saw a direct correlation between the number of daily blood glucose readings in CSII users with type 1 diabetes and the quality of glycemic control and glycemic variability. Frequent testers (more than five readings per day) had a better glycemic control (as shown by HbA1c and mean and median blood glucose levels) and had a lower glycemic variability (as shown by several glycemic variability indices) than patients with low glucose testing frequency.…”

Section: Discussionmentioning

confidence: 80%

“…The data from up to 299 participants with type 1 diabetes on CSII treatment collected at baseline of the ProAct study 7 could be included into this post hoc cross-sectional analysis ( MN]) and different short-acting insulins (64.3% insulin lispro, 26.4% insulin aspart, 5.3% insulin glulisine, and 3.7% regular human insulin). The distribution of the participants into the three glucose testing groups and the three insulin bolus groups is provided in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…Detailed information regarding study design and results have been published recently. 7 At baseline, the following parameters were obtained from medical records and/or the previous device used: HbA1c, weight, height, frequency of hypoglycemia (glucose meter readout of <70 mg/dL) and hyperglycemia (glucose meter readout of >300 mg/dL), mean number of insulin boluses, mean glucose values and their SDs, number of daily blood glucose measurements, and frequency of additional pump technology use, if applicable. This information was retrospectively collected for the last 3 months prior to study entry by device readouts.…”

Section: Methodsmentioning

confidence: 99%

“…We observed stable glycemic control with improvements in several observation parameters in several of the analyzed subgroups. 7 Participants who benefited most from the switch to the new pump system with respect to glycemic control were those with less CSII experience and patients with high glycated hemoglobin (HbA1c) values at the time of the pump switch. Indicators for an improvement in glycemic control were a decrease in the mean daily blood glucose levels, a decrease in glucose variability, and a decrease in HbA1c level (which reached the level of statistical significance in some subgroups).…”

Section: Introductionmentioning

confidence: 99%

“…These findings suggested a more confident diabetes management and a reduced need for correction boluses of the participating type 1 diabetes patients. 7 Prior to the study, patients had used different pump models, and data from the previous pump treatment results were also collected prior to the pump switch. This information was still independent from any study effects potentially induced by the ProAct study protocol and the new insulin pump features and is therefore more suitable to provide an understanding of real-world associations among treatment aspects, glucose control, and glycemic variability.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

Pfützner¹,

Weissmann

Mougiakakou

et al. 2015

Diabetes Technology & Therapeutics

Self Cite

View full text Add to dashboard Cite

Introduction: The ProAct study has shown that a pump switch to the Accu-Chek Ò Combo system (Roche Diagnostics Deutschland GmbH, Mannheim, Germany) in type 1 diabetes patients results in stable glycemic control with significant improvements in glycated hemoglobin (HbA1c) in patients with unsatisfactory baseline HbA1c and shorter pump usage time. Patients and Methods: In this post hoc analysis of the ProAct database, we investigated the glycemic control and glycemic variability at baseline by determination of several established parameters and scores (HbA1c, hypoglycemia frequency, J-score, Hypoglycemia and Hyperglycemia Indexes, and Index of Glycemic Control) in participants with different daily bolus and blood glucose measurement frequencies (less than four day, four or five per day, and more than five per day, in both cases). The data were derived from up to 299 patients (172 females, 127 males; age [mean -SD], 39.4 -15.2 years; pump treatment duration, 7.0 -5.2 years). Results: Participants with frequent glucose readings had better glycemic control than those with few readings (more than five readings per day vs. less than four readings per day: HbA1c, 7.2 -1.1% vs. 8.0 -0.9%; mean daily blood glucose, 151 -22 mg/dL vs. 176 -30 mg/dL; percentage of readings per month >300 mg/dL, 10 -4% vs. 14 -5%; percentage of readings in target range [80-180 mg/dL], 59% vs. 48% [P < 0.05 in all cases]) and had a lower glycemic variability ( J-score, 49 -13 vs. 71 -25 [P < 0.05]; Hyperglycemia Index, 0.9 -0.5 vs. 1.9 -1.2 [P < 0.05]; Index of Glycemic Control, 1.9 -0.8 vs. 3.1 -1.6 [P < 0.05]; Hypoglycemia Index, 0.9 -0.8 vs. 1.2 -1.3 [not significant]). Frequent self-monitoring of blood glucose was associated with a higher number of bolus applications (6.1 -2.2 boluses/day vs. 4.5 -2.0 boluses/day [P < 0.05]). Therefore, a similar but less pronounced effect on glycemic variability in favor of more daily bolus applications was observed (more than five vs. less than four bolues per day: J-score, 57 -17 vs. 63 -25 [not significant]; Hypoglycemia Index, 1.0 -1.0 vs. 1.5 -1.4 [P < 0.05]; Hyperglycemia Index, 1.3 -0.6 vs. 1.6 -1.1 [not significant]; Index of Glycemic Control, 2.3 -1.1 vs. 3.1 -1.7 [P < 0.05]). Conclusions: Pump users who perform frequent daily glucose readings have a better glycemic control with lower glycemic variability.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

Pfützner¹,

Weissmann

Mougiakakou

et al. 2015

Diabetes Technology & Therapeutics

Self Cite

View full text Add to dashboard Cite

show abstract

Advanced Pump Functions: Bolus Calculator, Bolus Types, and Temporary Basal Rates

Bonfanti¹,

Rigamonti²,

Frontino³

et al. 2016

Research Into Childhood-Onset Diabetes

View full text Add to dashboard Cite

Exenatide Add-on to Continuous Subcutaneous Insulin Infusion Therapy Reduces Bolus Insulin Doses in Patients with Type 2 Diabetes: A Randomized, Controlled, Open-Label Trial

Jiang

et al. 2016

Diabetes Ther

View full text Add to dashboard Cite

IntroductionThe objective of this study was to investigate the effect of adding exenatide to continuous subcutaneous insulin infusion (CSII) therapy on the precise insulin doses required by type 2 diabetic patients to maintain glycemic control.MethodsThis was a single-center, randomized, controlled, open-label trial. Uncontrolled T2D patients were recruited between March 2010 and November 2011 at Nanjing First Hospital, China. Subjects were randomly assigned (1:1) to either an exenatide add-on to CSII group or a CSII therapy only (i.e., control) group (n = 18, respectively) for 5 weeks. Patients were subjected to 3 days of continuous glucose monitoring (CGM) during the screening period and after therapy. The precise insulin doses, the times taken by the patients to achieve euglycemic control, and the mean amplitude of glycemic excursion (MAGE) at the endpoint were compared between the two groups. The primary endpoint was precise insulin dose differences between groups from baseline to the endpoint.ResultsA total of 36 subjects were admitted as inpatients. Patients in the exenatide add-on therapy group needed less insulin titration time to achieve glycemic control (3.67 ± 1.33 vs. 4.78 ± 1.00 days, P = 0.028) and significantly lower bolus insulin doses than the control group at the endpoint (total bolus, 0.13 ± 0.03 vs. 0.17 ± 0.04 U/kg, P = 0.02, breakfast bolus, 0.05 ± 0.01 vs. 0.06 ± 0.01 U/kg, P = 0.01, lunch bolus, 0.04 ± 0.01 vs. 0.06 ± 0.01 U/kg, P = 0.01, dinner bolus, 0.04 ± 0.01 vs. 0.05 ± 0.01 U/kg, P = 0.01, respectively). Moreover, the CGM data showed that patients in the exenatide add-on therapy group exhibited a significant reduction in MAGE as compared to the control group (2.96 ± 1.14 vs. 4.21 ± 1.39 mmol/L, P = 0.012).ConclusionOur data suggest that adding exenatide therapy to CSII therapy leads to an improvement in glycemic excursions and the use of smaller bolus insulin doses.Trial RegistrationChinese Clinical Trial Registry identifier, ChiCTR-PPR-15007045.

show abstract

ProAct Study: New Features of Insulin Pumps Improve Diabetes Management and Glycemic Control in Patients after Transition of Continuous Subcutaneous Insulin Infusion Systems

Cited by 25 publications

References 21 publications

Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

Glycemic Variability Is Associated with Frequency of Blood Glucose Testing and Bolus: Post Hoc Analysis Results from the ProAct Study

Advanced Pump Functions: Bolus Calculator, Bolus Types, and Temporary Basal Rates

Exenatide Add-on to Continuous Subcutaneous Insulin Infusion Therapy Reduces Bolus Insulin Doses in Patients with Type 2 Diabetes: A Randomized, Controlled, Open-Label Trial

Contact Info

Product

Resources

About