Résumé
Background and Aims: The aim of this study was to compare blood glucose and plasma insulin profiles after bolus insulin infusion by a patch pump (PP) versus a conventional pump (CP), directly after placement and after Day 3 of use.
Patients and Methods: Twenty patients with type 1 diabetes came in for two blocks of visits: one block of two visits while wearing the OmniPod (R) (Insulet Corp., Bedford, MA) insulin pump (PP) and one block of two visits while wearing the Medtronic Diabetes (Northridge, CA) Paradigm (R) pump (CP). Patients administered an identical mealtime insulin bolus of at least 6 IU.
Results: For PP, maximum glucose levels were 28.7% lower on Day 3 (P = 0.020), when maximum insulin levels were 30.3% higher (P = 0.002). For CP, maximum glucose levels were 26.5% lower on Day 3 (P = 0.015), when maximum insulin levels were 46.4% higher (P = 0.003). Glucose levels (mean [interquartile range]) were significantly lower on Day 3 for PP (168.2 [145.8] mg/dL vs. 139.4 [77.8] mg/dL; P = 0.013), but not significantly so for CP (159.0 [66.1] mg/dL vs. 139.5 [57.9] mg/dL; P = 0.084). Mean insulin levels were significantly higher on Day 3 for CP (195 [120] pmol/L vs. 230 [90] pmol/L; P = 0.01), but not significantly so for PP (178 [106] pmol/L vs. 194 [120] pmol/L; P = 0.099). There were no significant differences between the two catheter lengths.
Conclusions: Postprandial glycemic excursions were lower on Day 3 of catheter wear time, but there were no differences between PPs and CPs. These findings support the proposal that catheter wear time plays an important role in insulin absorption.