Introduction Multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII) are two modalities of treating type 1 diabetes mellitus (T1DM). The benefits of CSII on long-term metabolic control and outcomes compared to those of MDI are still debated. We investigated both vascular function and myocardial performance in T1DM adolescents on MDI or CSII treatment. Methods One hundred twenty-three T1DM subjects (mean age 14.16±2.55 years), 63 on MDI regimen, 60 on CSII, and 57 controls were enrolled. Anthropometric and biochemical characteristics were evaluated. Ultrasound assessments of carotid intima-media thickness (cIMT), flow-mediated dilatation of brachial artery, anteroposterior diameter of the infrarenal abdominal aorta (APAO), and transthoracic echocardiography were performed. Results T1DM subjects on the CSII regimen showed better glycemic control than those on MDI, expressed as glycated haemoglobin (HbA1c). c-IMT and APAO were higher in MDI than CSII patients (0.61±0.11 mm vs. 0.56±0.07 mm, p=0.04; 13.61±3.29 mm vs. 11.65±1.84 mm, p=0.01, respectively). Left and right Tei index and left E/e’ ratio were higher in MDI than CSII subjects (0.82±0.40 vs. 0.52±0.19, p=0.002; 0.86±0.41 vs. 0.64±0.1, p=0.02; 5.89±2.0 vs. 4.73±1.59, p=0.02, respectively). Multiple regression analyses showed that glucose level, HbA1c and diabetes onset were significantly related to vascular and echocardiographic parameters in MDI and CSII patients. Conclusions CSII regimen in T1DM adolescents improves glycemic control and seems to ameliorate endothelial function and global myocardial performance as compared to MDI therapy.

中文翻译：

---

青少年 1 型糖尿病患者的血管和心肌功能：胰岛素泵治疗与每日多次注射胰岛素方案

简介 每日多次注射 (MDI) 和连续皮下胰岛素输注 (CSII) 是治疗 1 型糖尿病 (T1DM) 的两种方式。与 MDI 相比，CSII 在长期代谢控制和结果方面的益处仍有争议。我们调查了接受 MDI 或 CSII 治疗的 T1DM 青少年的血管功能和心肌表现。方法 123 名 T1DM 受试者（平均年龄 14.16±2.55 岁），MDI 方案 63 人，CSII 方案 60 人，对照组 57 人。评估了人体测量学和生化特征。对颈动脉内膜中层厚度（cIMT）、血流介导的肱动脉扩张、肾下腹主动脉前后径（APAO）和经胸超声心动图进行超声评估。结果 接受 CSII 方案的 T1DM 受试者比接受 MDI 的受试者表现出更好的血糖控制，以糖化血红蛋白 (HbA1c) 表示。MDI 患者的 c-IMT 和 APAO 高于 CSII 患者（分别为 0.61±0.11 mm vs. 0.56±0.07 mm，p=0.04；13.61±3.29 mm vs. 11.65±1.84 mm，p=0.01）。MDI的左右Tei指数和左E/e'比高于CSII受试者（0.82±0.40 vs. 0.52±0.19, p=0.002; 0.86±0.41 vs. 0.64±0.1, p=0.02; 5.89±2.0 vs . 4.73±1.59, p=0.02，分别）。多元回归分析表明，血糖水平、HbA1c 和糖尿病发病与 MDI 和 CSII 患者的血管和超声心动图参数显着相关。结论 与 MDI 治疗相比，T1DM 青少年的CSII 方案改善了血糖控制，似乎改善了内皮功能和整体心肌功能。