Type 1 Diabetes: Insulin Treatment - Related Resources

Cochrane reviews

• Out-patient/home management of type 1 diabetes in children at diagnosis may not lead to any disadvantages in terms of metabolic control, acute complications and hospitalisations, psychosocial variables, or total costs Routine Hospital Admission Versus out-Patient or Home Care in Children at Diagnosis of Type 1 Diabetes Mellitus.
• Long acting insulin preparations appear to be superior in their nocturnal effect causing fewer episodes of nocturnal hypoglycaemia and resulting in a lower fasting glucose level than NPH insulin but their effect on glycosylated haemoglobin is clinically unremarkable. Their potential long-term adverse effects are unknown Intermediate Acting Versus (Ultra-)Long Acting Insulin for Type 1 Diabetes Mellitus.
• Short acting insulin analogues may provide a slightly better long-term glycaemic control as compared with regular human insulin in diabetic patients. Long-term efficacy and safety data are not available .
• Continuous insulin infusion treatment may modestly improve glycated hemoglobin levels and health-related quality of life in people with type 1 diabetes compared with conventional insulin therapy (multiple injections per day)Continuous Subcutaneous Insulin Infusion for Type 1 Diabetes.
• Intensive glycaemic control is effective in reducing the progression of nephropathy in people with type 1 diabetes. Glycaemic Control for Slowing the Progression of Microvascular Complications in Diabetes Mellitus
• During pregnancy, loose glycaemic control (fasting blood glucose 6.7 to 8.9 mmol/L) might possibly increase pre-eclampsia, caesarean sections, and macrosomia compared with tight-moderate glycaemic control (fasting blood glucose under or 6.7 mmol/L) in women with type 1 diabetes, although the data are insufficient Different Intensities of Glycaemic Control for Pregnant Women with Pre-Existing Diabetes.

Other evidence summaries

• Continuous subcutaneous infusion of insulin with portable pump appears to be effective in achieving good outcomes in type 1 diabetic patients but the effect is comparable to intensive schedules with multiple injections .

Literature