36 Months Continuous Subcutaneous Insulin Infusion (CSII) in Insulin Dependent Diabetes (IDDM) - Influence on Early Stages of Retinopathy, Nephropathy and Neuropathy - Psychological Analysis<sup>6</sup>)<sup>8</sup>)

Bibergeil, H; Hüttl, Irmtraud; Felsing, W.; U, Felsing; Seidlein, Ingetraut; Herfurth, S.; Dabels, J; Reichel, G; Lüder, Christiane; Günther, Albrecht; Bruns, W; Menzel, R

doi:10.1055/s-0029-1210672

Cited by 10 publications

(3 citation statements)

References 7 publications

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“…During the last several years in the treatment of insulin dependent diabetics more intensive insulin regimens have been increasingly used, employing either continuous subcutaneous insulin infusion (Tamborlane et al, 1980;Bibergeil et al, 1987) or multiple injections of short-acting insulin combined with intermediate-acting insulin in the evening to meet the "basal" insulin requirement during the night (Menzel, 1984).…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC¹)

Schulz

Menzel²,

Ratzmann³

et al. 2009

Exp Clin Endocrinol Diabetes

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To assess pharmacokinetics and biological activity of the new L-SNC insulin (Berlin-Chemie, a low immunogenic pork insulin in neutral solution purified by chromatography) ten healthy male subjects were connected to the BIOSTATOR. After an overnight fast 0.4 U of L-SNC insulin per kg body weight were injected subcutaneously in the thigh of each individual. Plasma insulin concentrations rose gradually reaching their maximum values after 8 hours. According to C-peptide levels there was some inhibition of endogenous insulin secretion. For the evaluation of insulin action we used the closed loop system (BIOSTATOR) which was transformed in its function into a glucose controlled dextrose infusion system. The amount of glucose delivered by the BIOSTATOR in order to maintain blood glucose steady state concentrations at the "basal" level was taken as a measure of biological activity of the injected insulin. The glucose infusion rate increased after insulin administration, reaching statistical significance after 3 hr. The maximum effect of L-SNC insulin was observed between 5 and 12 hours after injection. The overall duration of action of more than 16 hours meets the increasing need for insulin in the early morning in many diabetic patients. Therefore, L-SNC insulin should be recommended for intensified conventional insulin therapy to cover the night and to prevent dawn phenomenon in insulin dependent diabetics.

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Section: Introductionmentioning

confidence: 99%

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC¹)

Schulz

Menzel²,

Ratzmann³

et al. 2009

Exp Clin Endocrinol Diabetes

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“…On the contrary, during continuous insulin infusion with portable pumps the variations of blood glucose overnight were much less marked Jarrat 1986;. So in a similar group of 11 long-term type 1 diabetics on CSII treatment we achieved near normoglycemia (HbA1: 9.2 0.4%) after one year (Bibergeil et al, 1987). As well as a combination of a multiple insulin injection regime during the day with CSII over the night proved to be successful, too Schiffrin et al, 1984).…”

Section: Discussionmentioning

confidence: 96%

“…As well as a combination of a multiple insulin injection regime during the day with CSII over the night proved to be successful, too Schiffrin et al, 1984). Therefore the CSII seems to be the best possible approach to riear-normoglycemia in IDDM (Jarrat, 1986;Bibergeil et al, 1987). Nevertheless, the application and the acceptance of insulin pumps at present is limited for various reasons.…”

Section: Discussionmentioning

confidence: 99%

“Catheter-Pens” - an Alternative to Insulin Pump Treatment?^*)

Menzel¹,

Chlup²,

Jutzi³

et al. 2009

Exp Clin Endocrinol Diabetes

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Two types of insulin pens MADI and MD, were connected to subcutaneous catheters. These "catheter-pens" were used like hand-driven insulin pumps. Results after 1 year of treatment in 30 type 1 diabetics (HCP-negative; age at onset of diabetes 16.5 +/- 1.7 years; duration of diabetes 18.5 +/- 1.6 years, on multiple insulin injections before catheter-pen application): 1. better quality of life (reduction of frequency of needle pricks, more flexibility, inconspicuous application of insulin in public); 2. daily insulin--increased number of "injections" (4.2 +/- 0.1 vs 5.8 +/- 0.1, p less than 0.01), reduction of units per kg BW (0.70 +/- 0.02 vs 0.60 +/- 0.01, p less than 0.01), reduction of intermediate-acting insulin (14.1 +/- 1.3 vs 9.2 +/- 1.2 U/d, p less than 0.05); 3. no change of HbA1 (10.8 +/- 0.8 vs 10.2 +/- 0.2%, normal range 7.7 to 8.4%), mean blood glucose (MBG) in stress situation (8.4 +/- 0.4 vs 7.7 +/- 0.3 mmol/l), serum cholesterol and body weight, both within normal range; 4. improvement (p less than 0.05) of serum triglycerides, serum HDL-cholesterol, ratio of apolipoprotein A1/B; 5. rare skin reactions at the needle site. Conclusion. Catheter-pens offer a very convenient alternative for insulin administration in intensified conventional insulin treatment with multiple injections in type 1 diabetics.

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Continuous Subcutaneous Insulin Infusion

Lenhard¹,

Reeves²

2001

Arch Intern Med

178

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A tremendous amount of data suggest that near-normal glycemic control prevents or delays complications of diabetes, which has led to a dramatic increase in continuous subcutaneous insulin infusion (CSII) or insulin pump use. In this article, the data supporting CSII in type 1 diabetes is reviewed, and the advantages and disadvantages of CSII are analyzed. In addition, CSII use in specific situations is examined, including during childhood and pregnancy and while exercising. The published articles suggest that CSII provides better glycemic control than does conventional therapy and comparable to or slightly better control than multiple daily injections. The use of CSII may be especially indicated during pregnancy or for preconception care and for diabetes presenting in childhood or adolescence.

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36 Months Continuous Subcutaneous Insulin Infusion (CSII) in Insulin Dependent Diabetes (IDDM) - Influence on Early Stages of Retinopathy, Nephropathy and Neuropathy - Psychological Analysis⁶)⁸)

Abstract: Our experiences over three years demonstrate a positive effect of CSII on the metabolism as well as on the course of early stages of microangiopathy and neuropathy. A longer period of observations will be necessary to evaluate this, conclusively.

Cited by 10 publications

References 7 publications

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC¹)

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC¹)

“Catheter-Pens” - an Alternative to Insulin Pump Treatment?^*)

Continuous Subcutaneous Insulin Infusion

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36 Months Continuous Subcutaneous Insulin Infusion (CSII) in Insulin Dependent Diabetes (IDDM) - Influence on Early Stages of Retinopathy, Nephropathy and Neuropathy - Psychological Analysis6)8)

Abstract: Our experiences over three years demonstrate a positive effect of CSII on the metabolism as well as on the course of early stages of microangiopathy and neuropathy. A longer period of observations will be necessary to evaluate this, conclusively.

Cited by 10 publications

References 7 publications

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC1)

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC1)

“Catheter-Pens” - an Alternative to Insulin Pump Treatment?*)

Continuous Subcutaneous Insulin Infusion

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Product

Resources

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36 Months Continuous Subcutaneous Insulin Infusion (CSII) in Insulin Dependent Diabetes (IDDM) - Influence on Early Stages of Retinopathy, Nephropathy and Neuropathy - Psychological Analysis⁶)⁸)

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC¹)

Pharmacokinetics and Biological Activity of the New Intermediate-Acting Insulin L-SNC¹)

“Catheter-Pens” - an Alternative to Insulin Pump Treatment?^*)