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Abstract
To determine whether continuous subcutaneous insulin infusion (CSII) vs. multiple daily injections (MDI) therapy from near-diagnosis of type 1 diabetes is associated with reduced glycaemic variability (GV) and altered microRNA (miRNAs) expression. Adolescents (74% male) within 3-months of diabetes diagnosis (n = 27) were randomized to CSII (n = 12) or MDI. HbA1c, 1-5-Anhydroglucitol (1,5-AG), high sensitivity C-peptide and a custom TaqMan qPCR panel of 52 miRNAs were measured at baseline and follow-up (median (LQ-UQ); 535 (519–563) days). There were no significant differences between groups in baseline or follow-up HbA1c or C-peptide, nor baseline miRNAs. Mean ± SD 1,5-AG improved with CSII vs. MDI (3.1 ± 4.1 vs. − 2.2 ± − 7.0 mg/ml respectively, P = 0.029). On follow-up 11 miRNAs associated with diabetes vascular complications had altered expression in CSII-users. Early CSII vs. MDI use is associated with lower GV and less adverse vascular-related miRNAs. Relationships with future complications are of interest.
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Details
1 University of Sydney, NHMRC Clinical Trials Centre, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); Royal North Shore Hospital, Department of Endocrinology and Diabetes, Sydney, Australia (GRID:grid.412703.3) (ISNI:0000 0004 0587 9093)
2 University of Sydney, NHMRC Clinical Trials Centre, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); University of Melbourne, Department of Medicine, St Vincent’s Hospital, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X)
3 University of Sydney, NHMRC Clinical Trials Centre, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)
4 Royal North Shore Hospital, Department of Endocrinology and Diabetes, Sydney, Australia (GRID:grid.412703.3) (ISNI:0000 0004 0587 9093); University of Sydney, Northern Clinical School, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)
5 University of Western Australia, Perth, Australia (GRID:grid.1012.2) (ISNI:0000 0004 1936 7910); Perth Children’s Hospital, Diabetes and Endocrinology Services, Perth, Australia (GRID:grid.410667.2) (ISNI:0000 0004 0625 8600); Telethon Kids Institute, Perth, Australia (GRID:grid.414659.b) (ISNI:0000 0000 8828 1230)
6 University of Sydney, NHMRC Clinical Trials Centre, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); University of Melbourne, Department of Medicine, St Vincent’s Hospital, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X); The University of Sydney, NHMRC Clinical Trials Centre, Camperdown, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X)