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Flexible Intensive Insulin Therapy in Adults With Type 1 Diabetes and High Risk for Severe Hypoglycemia and Diabetic Ketoacidosis

Response to Pennant et al.

  1. Alexander Sämann, MD1,
  2. Ingrid Mühlhauser, MD2 and
  3. Ulrich A. Müller, MD1
  1. 1Department of Internal Medicine III, Friedrich-Schiller University, Jena, Germany
  2. 2Unit of Health Sciences and Education, University of Hamburg, Hamburg, Germany
  1. Address correspondence to Alexander Sämann, MD, Department of Internal Medicine III, Erlanger Allee 101, Friedrich-Schiller University, 07740 Jena, Germany. E-mail: alexander.saemann{at}med.uni-jena.de

As we previously discussed, regression to the mean was an important bias of our study, since it was not controlled (1,2). A subgroup analysis may or may not contribute to this bias. Pennant et al. (3) performed statistical simulations of baseline results and found that a reduction from 6.1 to 4.7 (95% CI ±0.2) hypoglycemic events per patient per year may be due to regression to the mean. However, there would still remain a reduction from 4.7 to 1.4 hypoglycemic events per patient per year, which was of clinical importance in this high-risk population.

The Diabetes Treatment and Teaching Program (DTTP) for type 1 diabetes has been extensively studied in …

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