2004年美国糖尿病协会第64届年会 ADA 64th Annual Scientific Sessions June 4-8, 2004 Orange County Convention Center, Orlando, Florida Authors: GEREMIA B. BOLLI, FABIO CAPANI, PHILIP D. HOME, et al. A superior cost-efficacy profile has been demonstrated for a multiple daily infusion (MDI) regimen based on newer insulin analogues as compared to the continuous subcutaneous insulin infusion (CSII) regimen. Comparison of a Multiple Daily Injection Regimen with Once-Daily Insulin Glargine Basal Insulin and Mealtime Lispro, to Continuous Subcutaneous Insulin Infusion: A Randomised, Open, Parallel Study Conclusions: both CSII and a once-daily glargine-based MDI regimen improve BG to a similar extent with no differences in mean BG, HbAm1cn, BG excursions, and frequency of hypoglycaemia. A glargine-based MDI regimen is less expensive and therefore more cost-effective when used in an unselected population of people with Type 1 diabetes. 有数据显示，持续皮下输注的胰岛素给药方案比每日多次注射胰岛素加NPH作为基础胰岛素能更好地控制1型糖尿病。Geremia B. Bolli等所进行的涉及多个国家的多中心研究，比较了持续皮下输注（Lispro）和每日注射一次胰岛素类似物Glargine（加餐时Lispro注射）这两种胰岛素给药方案的优劣。 研究人员将未接受过这两种治疗方法的1型糖尿病患者（HbAm1cn≤9.0%）随机分为两组：持续皮下输注组（continuous subcutaneous insulin infusion，CSII，n=28）和每日注射组（multiple daily insulin injections，MDI，n=29）,疗程均为6个月。治疗结果显示，CSII组患者HbAm1从7.7±0.7%降至7.0±0.8%，MDI组由7.8±0.6%降至7.2±0.7%; 血糖分别由164±41mg/dL降至146±32mg/dL和由160±30mg/dL降至144±20mg/dL。6个月中两组患者出现低血糖（BG＜72mg/dL）的几率无显著性差异。严重低血糖只出现过2次。针对总治疗费用的比较则显示SCII方案的费用是MDI方案的4倍。 研究人员最后的结论是，持续皮下输注胰岛素和在多次注射胰岛素基础上每日应用一次Glargine，这两种方案在血糖控制、HbAm1cn水平的控制以及出现低血糖的几率方面无显著差异。但基于Glargine的MDI方案的费用要低的多，因此其性价比更高。