Factors influencing insulin requirements in using continuous subcutaneous insulin infusion or multiple daily injections in type 2 diabetes

doi:10.4239/wjd.v16.i7.106470

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Jul 15, 2025 (publication date) through Jul 25, 2025

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Diabetes. Jul 15, 2025; 16(7): 106470
Published online Jul 15, 2025. doi: 10.4239/wjd.v16.i7.106470

Table 1 Patients’ characteristics, mean ± SD/n (%)

Factors	MDI therapy (n = 561)	CSII therapy (n = 393)
Age in years, median (interquartile)	57.0 (49.0, 65.0)	56.0 (48.5, 64.0)
Sex
Men	351 (58.5)	235 (56.6)
Women	249 (41.5)	180 (43.4)
Duration of diabetes in years, median (interquartile)	10.0 (5.0, 15.0)	9.0 (3.0, 13.5)^b
BMI in kg/m², median (interquartile)	23.7 (21.7, 26.0)	24.9 (23.0, 27.0)^b
WC in cm	87.7 ± 10.0	90.0 (85.0, 96.0)^b
FPG in mmol/L, median (interquartile)	8.6 (6.8, 10.8)	8.3 (6.4, 10.6)
HbA1c as %, median (interquartile)	9.7 (7.8, 11.3)	9.5 (7.9, 11.0)
Fasting C-peptide in nmol/L, median (interquartile)	302.0 (180.7, 483.7)	324.3 (217.6, 468.9)
2 hour-postprandial C-peptide in nmol/L, median (interquartile)	577.4 (305.0, 1051.3)	609.9 (389.6, 1003.3)
Total cholesterol in mmol/L, median (interquartile)	4.0 (3.6, 5.1)	4.1 (3.6, 5.2)
LDL cholesterol in mmol/L, median (interquartile)	3.3 (2.4, 3.4)	3.4 (2.6, 3.5)
HDL cholesterol in mmol/L, median (interquartile)	1.0 (0.8, 1.4)	1.0 (0.8, 1.3)
Triglycerides in mmol/L, median (interquartile)	1.7 (1.3, 2.2)	1.7 (1.4, 2.3)

^bP < 0.01.

BMI: Body mass index; CSII: Continuous subcutaneous insulin infusion; MDIs: Multiple daily injections; WC: Waist circumference; FPG: Fasting plasma glucose; HbA1c: Glycated hemoglobin; HDL cholesterol: High-density lipoprotein cholesterol; LDL cholesterol: Low-density lipoprotein cholesterol.

Table 2 Differences in insulin dose among patients receiving multiple daily injection therapy and continuous subcutaneous insulin infusion therapy

Patients	Therapy	TDD	TDD/kg	TBa%
All patients, median (interquartile)	MDI therapy (n = 561)	30.00 (24.00, 38.00)	0.49 (0.38, 0.60)	43.00 (36.00, 50.00)
All patients, median (interquartile)	CSII therapy (n = 393)	26.40 (21.60, 32.40)^b	0.40 (0.32, 0.49)^b	42.00 (40.00, 50.00)^b
HbA1c < 8%, median (interquartile)	MDI therapy (n = 153)	25.00 (21.00, 29.00)	0.41 (0.33, 0.48)	44.40 (40.00, 49.00)
HbA1c < 8%, median (interquartile)	CSII therapy (n = 103)	21.60 (16.80, 27.00)^a	0.36 (0.29, 0.42)^a	40.00 (30.00, 50.00)^a
HbA1c ≥ 8%, median (interquartile)	MDI therapy (n = 408)	31.00 (26.00, 39.00)	0.51 (0.42, 0.62)	45.30 (36.40, 53.70)
HbA1c ≥ 8%, median (interquartile)	CSII therapy (n = 290)	27.20 (21.70, 33.00)^b	0.43 (0.34, 0.50)^b	44.40 (40.00, 50.00)

^aP < 0.05.

^bP < 0.01.

HbA1c: Glycated hemoglobin; CSII: Continuous subcutaneous insulin infusion; MDI: Multiple daily injection; TBa%: Ratio of total basal insulin dose to total daily insulin dose; TDD: Total daily insulin dose; TDD/kg: Total daily insulin dose per kilogram.

Table 3 Spearman’s rank correlation analysis of insulin demand parameters in the multiple daily injections and continuous subcutaneous insulin infusion groups

Factors	MDI			CSII
Factors	TDD	TDD/kg	TBa%	TDD	TDD/kg	TBa%
BMI in kg/m²	0.23^b	0.13^a	0.11^a	0.31^b	0.22^b	0.10^a
WC in cm	0.28^b	0.15^a	0.11^a	0.30^b	0.18^b	0.14^a
FPG in mmol/L	0.26^b	0.27^a	0.26^b	0.35^b	0.34^b	0.21^b
HbA1c, %	0.23^b	0.34^b	0.16^b	0.32^b	0.33^b	0.07

^aP < 0.05.

^bP < 0.01.

HbA1c: Glycated hemoglobin; BMI: Body mass index; WC: Waist circumference; FPG: Fasting plasma glucose; CSII: Continuous subcutaneous insulin infusion; MDI: Multiple daily injection; TBa%: Ratio of total basal insulin dose to total daily insulin dose; TDD: Total daily insulin dose; TDD/kg: Total daily insulin dose per kilogram.

Table 4 Multiple linear regression of insulin demand parameters in the multiple daily injections group

Factors	TDD	TDD/kg	TBa%
Age in years	0.01	0.12	-0.07
Duration of diabetes in years	0.06	0.02	0.08
BMI in kg/m²	0.26^b	-0.19^b	0.03
WC in cm	0.30^b	-0.03	0.13
FPG in mmol/L	0.18^b	0.18^b	0.21^b
HbA1c, %	0.24^b	0.25^b	0.09

^bP < 0.01.

HbA1c: Glycated hemoglobin; BMI: Body mass index; WC: Waist circumference; FPG: Fasting plasma glucose; TBa%: Ratio of total basal insulin dose to total daily insulin dose; TDD: Total daily insulin dose; TDD/kg: Total daily insulin dose per kilogram.

Table 5 Multiple linear regression of insulin demand parameters in continuous subcutaneous insulin infusion group

Factors	TDD	TDD/kg	%TBa
Age in years	-0.10	-0.01	-0.15^a
Duration of diabetes in years	0.08	0.10	0.05
BMI in kg/m²	0.19^a	-0.14	-0.27^a
WC in cm	0.20^a	-0.02	0.37^b
FPG in mmol/L	0.28^b	0.29^b	0.22^b
HbA1c, %	0.22^b	0.23^b	-0.12

^aP < 0.05.

^bP < 0.01.

Citation: Sun RM, Dai DX, Xu F, Ling YL, Xie ZJ. Factors influencing insulin requirements in using continuous subcutaneous insulin infusion or multiple daily injections in type 2 diabetes. World J Diabetes 2025; 16(7): 106470
URL: https://www.wjgnet.com/1948-9358/full/v16/i7/106470.htm
DOI: https://dx.doi.org/10.4239/wjd.v16.i7.106470