Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Injections: The Impact of Baseline A1c
Response to Blumer
- Ravi Retnakaran, MD12 and
- Bernard Zinman, MD12
- Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada
- Address correspondence to Dr. Bernard Zinman, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Lebovic Building, 5th Floor, Room L5-024, 600 University Ave., Toronto, Ontario, Canada, M5G 1X5. E-mail: zinman{at}mshri.on.ca
We agree with Blumer’s (1) contention that patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) therapy represent a well-motivated patient population. In this context, he asks whether differences in patient motivation (as reflected in adherence to frequent self-monitoring of blood glucose and regular contact with diabetes educators) may underlie the finding of improved glycemic control with CSII as compared with multiple daily insulin injection (MDII) therapy in our recent pooled analysis …
