Continuous Subcutaneous Insulin Infusion Initiation Is Associated With Blood Pressure Reduction in Adults With Type 1 Diabetes.
blood pressure
cardiovascular disease
continuous subcutaneous insulin infusion
insulin pump therapy
type 1 diabetes
Journal
Journal of diabetes science and technology
ISSN: 1932-2968
Titre abrégé: J Diabetes Sci Technol
Pays: United States
ID NLM: 101306166
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
pubmed:
15
1
2019
medline:
18
8
2020
entrez:
15
1
2019
Statut:
ppublish
Résumé
In type 1 diabetes (T1D) continuous subcutaneous insulin infusion (CSII) use has been associated with lower risks for mortality and diabetes-related complications when compared to multiple daily injections. There are limited data on the effect of CSII on blood pressure (BP). We aimed to evaluate the relationship between CSII initiation and BP changes. We performed a retrospective, single-center, observational study including all adults with T1D who initiated CSII between 2001 and 2014. Mean systolic BP levels were calculated from values obtained up to 15 months before and up 15 months after CSII initiation. We studied 436 adults (46% male; mean [95% CI] age: 45 [36, 54] years, duration of diabetes: 20.3 [19.1, 21.5] years). CSII was associated with the following changes (post minus pre CSII levels) in mean (95% CI) SBP and DBP levels, respectively: whole cohort (N = 436): -2 (-1, -3), We showed BP reduction in association with CSII therapy particularly in those on antihypertensive medication. These original findings may partly explain the cardiovascular and mortality benefits associated with CSII therapy.
Sections du résumé
BACKGROUND
In type 1 diabetes (T1D) continuous subcutaneous insulin infusion (CSII) use has been associated with lower risks for mortality and diabetes-related complications when compared to multiple daily injections. There are limited data on the effect of CSII on blood pressure (BP). We aimed to evaluate the relationship between CSII initiation and BP changes.
METHODS
We performed a retrospective, single-center, observational study including all adults with T1D who initiated CSII between 2001 and 2014. Mean systolic BP levels were calculated from values obtained up to 15 months before and up 15 months after CSII initiation.
RESULTS
We studied 436 adults (46% male; mean [95% CI] age: 45 [36, 54] years, duration of diabetes: 20.3 [19.1, 21.5] years). CSII was associated with the following changes (post minus pre CSII levels) in mean (95% CI) SBP and DBP levels, respectively: whole cohort (N = 436): -2 (-1, -3),
CONCLUSIONS
We showed BP reduction in association with CSII therapy particularly in those on antihypertensive medication. These original findings may partly explain the cardiovascular and mortality benefits associated with CSII therapy.
Identifiants
pubmed: 30636544
doi: 10.1177/1932296818822818
pmc: PMC6610598
doi:
Substances chimiques
Hypoglycemic Agents
0
Insulin
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
691-697Références
Diabetes Care. 2000 Sep;23(9):1232-5
pubmed: 10977011
J Hypertens. 2001 Sep;19(9):1633-41
pubmed: 11564984
Diabetes Care. 2004 Nov;27(11):2590-6
pubmed: 15504991
Diabet Med. 2008 Mar;25(3):326-32
pubmed: 18307459
Diabet Med. 2008 Jul;25(7):765-74
pubmed: 18644063
Diabet Med. 2009 Jun;26(6):602-8
pubmed: 19538235
Diabetes. 1990 Mar;39(3):289-98
pubmed: 2137801
N Engl J Med. 2012 Apr 26;366(17):1616-24
pubmed: 22533577
Pediatr Diabetes. 2013 Nov;14(7):504-11
pubmed: 23659762
Acta Diabetol. 2014 Dec;51(6):955-62
pubmed: 25274393
BMJ. 2015 Jun 22;350:h3234
pubmed: 26100640
Diabet Med. 2015 Nov;32(11):1445-52
pubmed: 26331364
J Clin Endocrinol Metab. 2015 Nov;100(11):4181-8
pubmed: 26390102
PLoS One. 2016 Apr 06;11(4):e0153033
pubmed: 27050468
Pediatr Diabetes. 2018 Aug;19(5):979-984
pubmed: 29446511
Diabetes Res Clin Pract. 2018 Jul;141:148-155
pubmed: 29733870
Diabetologia. 1981 Sep;21(3):165-71
pubmed: 7028550
Hypertension. 1994 Feb;23(2):195-9
pubmed: 8307628