Intraperitoneal Therapy Superior to multiple insulin injections in Early Diabetic Nephropathy: Study
Researchers have found in a new study that Intraperitoneal (IP) therapy demonstrated better efficacy than MSII in improving both renal function and glycemic control in patients with early-stage diabetic nephropathy (DN). It was also associated with fewer adverse events. However, potential risks linked to IP therapy should be carefully considered when making clinical decisions
The comparative efficacy and safety of insulin pump (IP) therapy versus multiple subcutaneous insulin injections (MSIIs) in patients with early-stage diabetic nephropathies (DNs) remain subjects of ongoing clinical debate. This systematic review and meta-analysis aimed to evaluate the differences in renal function, glycemic control, and safety outcomes between IP therapy and MSII in patients with early-stage DN.
A comprehensive literature search was conducted across Chinese-language databases [China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Data, and Chinese Biomedical Literature Database (CBM)] and English-language databases [National Library of Medicine, USA (PubMed), Web of Science, and Excerpta Medica Database (EMBASE)] from inception to January 2023. Randomized controlled trials comparing IP therapy with MSII in individuals with early-stage DN were included. The methodological quality of the included studies was assessed, and relevant data were extracted for quantitative meta-analysis.
A total of 23 randomized controlled trials met the inclusion criteria. Meta-analysis demonstrated that IP therapy was associated with significant improvements in renal and glycemic indicators: urinary albumin excretion rate: odds ratio (OR) =−2.03, 95% confidence interval (CI): −2.53, −1.52, P<0.001; 24-hour urinary protein volume: OR =−0.96, 95% CI: −1.51, −0.41, P<0.001; β2-microglobulin: OR =−0.68, 95% CI: −0.81, −0.55, P=0.04; renal function: OR =−0.38, 95% CI: −0.77, 0.00, P<0.001; glycated hemoglobin: OR =−0.83, 95% CI: −1.22, −0.43, P<0.001; fasting plasma glucose: OR =−1.76, 95% CI: −2.31, −1.22, P=0.02; 2-hour postprandial glucose: OR =−1.34, 95% CI: −1.64, −1.05, P<0.001. Regarding safety, lower incidences of hypoglycemia (OR =3.43, 95% CI: 1.84–6.39, P=0.98) and blurred vision (OR =2.53, 95% CI: 1.20–5.36, P>0.99) were observed with IP therapy. However, these differences were not statistically significant and the findings should be interpreted cautiously due to high P values and limited event counts.
When compared to MSII, IP therapy demonstrated superior efficacy in improving renal and glycemic parameters in individuals with early-stage DN. Although associated with a reduced incidence of adverse events, potential risks related to IP use should be carefully evaluated during clinical decision-making.
Reference:
Xu, M., Huang, J.-J., Qin, X.-H., & Zhu, S.-Y. (2026). Comparative efficacy and safety of insulin pump versus multiple daily injections in early-stage diabetic nephropathy: A systematic review and meta-analysis. Translational Andrology and Urology, 15(3). https://tau.amegroups.org/article/view/150125
Keywords:
Intraperitoneal, Therapy, Superior, multiple, insulin, injections, Early Diabetic Nephropathy, Study, Diabetic nephropathies (DNs); insulin pump (IP); meta-analysis; multiple subcutaneous insulin injection (MSII), Xu, M., Huang, J.-J., Qin, X.-H., & Zhu, S.-Y
