Though results from the DCCT study showed that intensive therapy can reduce complications of type I diabetes, it also showed that it can increase the chance of hypoglycemia.
Hypoglycemia occurred three times as often in patients undergoing multiple daily injections (MDI) than to those using conventional therapies. A recent study headed by Bruce Bode, MD, of the Atlanta Diabetes Association demonstrated that continuous subcutaneous insulin infusion (CSII) provides the same health benefits as intensive therapy with less risk of a severe hypoglycemic reaction.
Bode’s study was conducted on 55 patients who spent a year on intensive therapy, then a year on the pump. Many of the subjects did not have consistent control of their blood glucose levels, with HbA1c levels above eight percent. Many also had histories of recurrent severe hypoglycemia and suffered from hypoglycemic unawareness. The researchers recorded HbA1c levels, body weight and hypoglycemic incidents at regular intervals throughout both the MDI and CSII phases.
While patients experienced a total of 76 severe hypoglycemic events during the one-year MDI period, only 12 severe episodes were observed during the first year of CSII therapy. Those subjects who began the experiment with high HbA1c levels reduced their levels during the first year of intensive therapy, but leveled off in the second year of pump therapy.
Patients receiving long-term CSII therapy maintained an excellent level of glycemic control while significantly reducing the occurrence of severe hypoglycemia.