medwireNews: Using an insulin pump rather than multiple daily injections (MDI) may help protect people with type 1 diabetes from developing fatty liver disease, report researchers.
Presenting the findings at the 58th EASD Annual Meeting in Stockholm, Sweden, Lutgarda Bozzetto (Federico II University, Naples, Italy) suggested the more physiologic insulin delivery achieved with continuous subcutaneous insulin infusion versus MDI, resulting in a lower daily insulin dose, may underlie these benefits for the liver.
However, she also stressed that the findings from the cross-sectional study cannot establish causation. As expected, the 245 study participants using insulin pumps had a significantly lower daily insulin dose than the 414 using MDI, at an average of 0.54 versus 0.63 IU/kg, but they also had lower plasma triglyceride levels (76 vs 85 mg/dL) and a smaller waist circumference (85 vs 87 cm).
Glycated hemoglobin levels and estimated glucose disposal rate were similar between the groups, as were age, blood pressure, and BMI.
None of the participants had a history of chronic liver disease, but those using pumps had a significantly lower average Hepatic Steatosis Index (HSI) than those using MDI, at 36.4 versus 37.4 points, and also a significantly lower Fatty Liver Index (FLI), at 20.2 versus 24.8 points.
These differences proved to be restricted to women, who had average HSI values of 35.6 versus 36.9 with continuous subcutaneous insulin infusion versus MDI, and FLI values of 13.5 versus 19.8. The corresponding values in men were 37.2 versus 37.7 and 28.2 versus 28.9.
Looking specifically at women, the researchers found no differences in waist circumference according to insulin delivery method, but women using pumps had significantly lower plasma triglycerides than those using MDI, at 65 versus 79 mg/dL.
“It is likely that female gender offers the optimal hormonal milieu to exploit the beneficial effects of lower peripheral insulin on visceral adipose tissue distribution,” Bozzetto concluded.
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