{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:42:31Z","timestamp":1773286951166,"version":"3.50.1"},"reference-count":42,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,12,2]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine if continuous subcutaneous insulin infusion (CSII) therapy is associated with lower glycated\nhaemoglobin (HbA1c) variability (long-term glycaemic variability; GV) relative to multiple daily injection (MDI) treatment in adults with type 1 diabetes mellitus (T1DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective audit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>Clinic records from 506 adults with T1DM from two tertiary Australian hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Long-term GV was assessed by HbA1c SD and coefficient of variation (CV) in adults on established MDI or CSII therapy, and in a subset changing from MDI to CSII.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Adults (n=506, (164 CSII), 50% women, mean\u00b1SD\u2009age 38.0\u00b115.3\u2009years, 17.0\u00b113.7\u2009years diabetes, mean HbA1c 7.8%\u00b11.2% (62\u00b113\u2009mmol\/mol) on CSII, 8.0%\u00b11.5% (64\u00b116\u2009mmol\/mol) on MDI) were followed for 4.1\u00b13.6\u2009years. CSII use was associated with lower GV (HbA1c SD: CSII vs MDI 0.5%\u00b10.41% (6\u00b16\u2009mmol\/mol) vs 0.7%\u00b10.7% (9\u00b18\u2009mmol\/mol)) and CV: CSII vs MDI 6.7%\u00b14.6% (10\u00b110\u2009mmol\/mol) vs 9.3%\u00b17.3% (14\u00b113\u2009mmol\/mol), both p&lt;0.001. Fifty-six adults (73% female, age 36\u00b113\u2009years, 16\u00b113\u2009years diabetes, HbA1c 7.8%\u00b10.8% (62\u00b19\u2009mmol\/mol)) transitioned from MDI to CSII. Mean HbA1c fell by 0.4%. GV from 1\u2009year post-CSII commencement decreased significantly, HbA1c SD pre-CSII versus post-CSII 0.7%\u00b10.5% (8\u00b15\u2009mmol\/mol) vs 0.4%\u00b10.4% (5\u00b14\u2009mmol\/mol); p&lt;0.001, and HbA1c CV 9.2%\u00b15.5% (13\u00b18\u2009mmol\/mol) vs 6.1%\u00b13.9% (9\u00b15\u2009mmol\/mol); p&lt;0.001.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In clinical practice with T1DM adults relative to MDI, CSII therapy is associated with lower HbA1c GV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-033059","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T04:25:39Z","timestamp":1577679939000},"page":"e033059","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["HbA1c variability in adults with type 1 diabetes on continuous subcutaneous 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S","family":"Januszewski","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia"},{"name":"The University of Melbourne Medicine at St Vincent's Hospital, Fitzroy, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Calandro","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anandwardhan A","family":"Hardikar","sequence":"additional","affiliation":[{"name":"NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0870-4032","authenticated-orcid":false,"given":"David N","family":"O'Neal","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of 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