Abstract:

BACKGROUND: Insulin is necessary for patients with type 1 diabetes mellitus (T1DM) in residual lifetime, and it is dispute the superiority and inferiority of multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII).
OBJECTIVE: To investigate the efficacy and safety of CSII and MDI in patient with T1DM using systematic review.
METHODS: PubMed, Embase, the Cochrane Library, Chinese biomedical literature database, CNKI, VIP and bibliographies of retrieved articles for randomized controlled trials (RCTs) comparing CSII versus MDI for patient with T1DM were analyzed using Review Manager 5.0.
RESULTS AND CONCLUSION: Nine RCTs totaling 320 participants were included. The Meta analysis showed that there were significant differences in glycosylated hemoglobin between CSII group and MDI group [SMD=-0.43, 95%CI (-0.69, -0.18)]. The differences of two group in insulin requirement [WMD=-0.16, 95%CI (-0.29, -0.03)], all included studies suggested higher treatment satisfaction could be received using CSII therapy. Compared with MDI, CSII is more effective form in controlling blood sugar, reducing the daily insulin requirement, and improving the score of treatment satisfaction.