Insulin pump therapy in type 1 diabetes is associated with lower indices of Non-Alcoholic Fatty Liver in non-obese women but not men

• Published in: Diabetes research and clinical practice 2023-08, Vol.202, p.110816-110816, Article 110816
• Main Authors: Pepa, Giuseppe Della, Lupoli, Roberta, Masulli, Maria, Boccia, Rosalia, De Angelis, Raffaele, Gianfrancesco, Salvatore, Rainone, Carmen, Rivellese, Angela Albarosa, Annuzzi, Giovanni, Bozzetto, Lutgarda
• Format: Article
• Language: English
• Subjects: Continuous subcutaneous insulin infusion; Non-alcoholic fatty liver; Peripheral insulin; Sex; Type 1 diabetes
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2023.110816

•Fatty liver is a raising concern in type 1 diabetes.•Type of insulin administration could play a pathophysiological role in fatty liver.•Insulin pump therapy is associated with lower fatty liver indices in women. Non-Alcoholic Fatty Liver Disease (NAFLD) is a raising concern in type 1 diabetes (T1D) patients. We evaluated whether multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) may differentially affect NAFLD. NAFLD was assessed by Fatty Liver Index (FLI) and Hepatic Steatosis Index (HSI) in 659 T1D patients treated by MDI (n = 414, 65% men) or CSII (n = 245, 50% men) without alcohol abuse or other liver diseases. Clinical and metabolic differences between MDI and CSII participants were also evaluated according to sex. Compared with the MDI cohort, CSII users had a significantly lower FLI (20.2 ± 21.2 vs. 24.8 ± 24.3; p = 0.003), HSI (36.2 ± 4.4 vs. 37.4 ± 4.4; p = 0.003), waist circumference (84.6 ± 11.8 vs. 86.9 ± 13.7 cm; p = 0.026), plasma triglyceride (76.0 ± 45.8 vs. 84.7 ± 58.3 mg/dl; p = 0.035), and daily insulin dose (0.53 ± 0.22 vs. 0.64 ± 0.25 IU/kg body weight; p