Continuous subcutaneous insulin infusion (CSII) in the Veneto region: efficacy, acceptability and quality of life

Bruttomesso, Daniela; Pianta, A; Crazzolara, Dalia; Scaldaferri, E.; Lora, Lucia; Guarneri, G.; Mongillo, A.; Gennaro, Renato; Miola, M.; Moretti, Matteo; Confortin, Loris; Beltramello, Giampietro; Pais, M; Baritussio, Aldo; Casíglia, Edoardo; Tiengo, Antonio

doi:10.1046/j.1464-5491.2002.00750.x

Cited by 78 publications

(81 citation statements)

References 34 publications

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“…[9][10][11][12][13]15 However, relatively fewer studies were conducted in patients with type 2 diabetes, and the studies in type 2 diabetes patients generally showed no significant difference between CSII and MDI with respect to HbA1c and risk of hypoglycemia. [17][18][19][20] Recently, growing attention has been paid to the hyperglycemia control in perioperative patients with diabetes, and experience is gradually being accumulated in this regard.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple daily injection (MDI) of insulin is another common form of IIT, but in patients with type 1 diabetes, CSII provides better glycemic control and stability without a higher rate of hypoglycemia. [9][10][11][12][13] However, most studies for CSII were conducted in patients with type 1 diabetes who received long-term CSII therapy, and very few studies were focused on perioperative shortterm application of CSII in different types of diabetes patients.…”

Section: Introductionmentioning

confidence: 99%

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Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Cai

et al. 2013

Diabetes Technology & Therapeutics

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Background: Hyperglycemia is common and hard to control in surgical patients with diabetes. We retrospectively investigated short-term effects of continuous subcutaneous insulin infusion (CSII) in perioperative patients with diabetes. Patients and Methods: Perioperative patients with diabetes discharged between January 1, 2006 and January 1, 2012 were included. Glucose control and postoperative outcomes were compared between the patients using CSII or non-CSII insulin therapy. Results: We identified 108 pairs of patients matched by propensity and surgical category who were using CSII therapy (CSII group) or non-CSII insulin therapy (control group). The CSII group had significantly lower fasting glucose levels (on the first postoperative day, 9.06 -3.09 mmol/L vs. 11.05 -4.19 mmol/L; P = 0.003) and lower mean glucose levels (on the operation day, 9.93 -2.65 mmol/L vs. 12.05 -3.86 mmol/L; P = 0.001). The CSII group also had a lower incidence of fever (on the first postoperative day, 30.4% vs. 53.2%; P = 0.005). Furthermore, patients in the CSII group experienced significantly shorter postoperative intervals for suture removal (P = 0.02) and hospital discharge (P = 0.03). No significant difference in the total medical expenditure was observed between the two groups (P = 0.47). We also made a comparison between the 30 pairs of patients who were using CSII or multiple daily insulin injection therapy but observed no significant difference between these two therapies in glucose control or postoperative outcomes. Conclusions: Compared with non-CSII insulin therapy, even short-term implementation of CSII can improve the postoperative control of glucose, reduce the incidence of postoperative fever, and shorten the time for suture removal and discharge in surgical patients with diabetes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Cai

et al. 2013

Diabetes Technology & Therapeutics

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“…5,6,[12][13][14] In the present study, results showed that CSII therapy could also significantly reduce the total daily insulin dose compared with MDI therapy in Chinese patients with type 2 diabetes mellitus. The incidence of hypoglycaemia during CSII therapy was also significantly lower than that during MDI therapy.…”

Section: Discussionmentioning

confidence: 55%

“…[5][6][7] Evidence suggests that CSII also appears to be a good alternative for the treatment of patients with type 2 diabetes mellitus who do not respond to MDI regimens. 8 In China, neutral protamine hagedorn (NPH)-based MDI and CSII methods for glycaemic control are routinely used for hospitalized patients with type 2 diabetes mellitus.…”

Section: Introductionmentioning

confidence: 99%

Comparison of continuous subcutaneous insulin infusion and multiple daily insulin injections in Chinese patients with type 2 diabetes mellitus

et al. 2014

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Objective: To investigate prospectively the insulin dose requirements of Chinese patients with type 2 diabetes mellitus treated with either multiple daily insulin injections (MDI) or continuous subcutaneous insulin infusion (CSII) therapy during a 2-week therapeutic intervention. Methods: Patients with type 2 diabetes mellitus were randomly assigned to MDI or CSII therapy. The effects of the two treatment methods were determined based on blood glucose parameters, total daily insulin dose and rates of hypoglycaemia. Results: A total of 609 patients were enrolled in the study. Glycaemic goals were achieved after a mean AE SD of 6.90 AE 2.10 and 5.44 AE 2.22 days' treatment in the MDI and CSII groups, respectively. Once stabilized, the mean AE SD total daily insulin doses were 37.12 AE 10.19 IU and 32.58 AE 8.78 IU for the MDI and CSII groups, respectively. Once stabilized, the mean AE SD total basal and bolus doses were 19.46 AE 7.95 IU/day and 17.66 AE 3.53 IU/day for the MDI group, and 22.79 AE 7.55 IU/ day and 9.81 AE 2.64 IU/day for the CSII group, respectively. There were significant differences in the total, basal and bolus insulin doses between the two groups. Conclusion: CSII therapy may be considered as an effective method to achieve good glycaemic control in Chinese patients with type 2 diabetes mellitus.

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“…Pumps provide an accurate history of insulin use through their menus and often this history can be uploaded and displayed as a graph for purposes of trend analysis. Furthermore, insulin pumps result in fewer episodes of hyperglycemia and hypoglycemia than multiple daily injections (9,10). Taken together, insulin pump therapy is recommended as a treatment modality of choice in selected patients.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Trigger for Cutaneous Mastocytosis: The Insulin Pump

Akelma¹,

Buluş²,

Koçak³

et al. 2017

Asthma Allergy Immunol

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ÖZMastositoz cilt başta olmak üzere kemik iliği, karaciğer, dalak, lenf nodları ve gastrointestinal sistemde mast hücrelerinin klonal artışı karakterize nadir görülen bir hastalıktır. Bazı faktörlerin mastositozlu hastaların semptomlarını tetiklediği bilinmektedir. Bu yazıda, Tip 1 diabetes mellitus (DM) olan hastada, insülin pompa tedavisine bağlı semptomları tetiklenen kutanöz mastositoz olgusu sunulmuştur. Kutanöz mastositoz ve Tip 1 DM tanısı konulan 13 yaşındaki erkek çocukta, insülin pompa ile verilen insülin lispro tedavisinden 2-3 gün sonra meydana gelen çok sayıda kaşıntılı papüler lezyonlar görüldü. Mastositoz olarak değerlendirilen lezyonlardan alınan punch biyopside papiller dermiste yaygın mast hücre infiltrasyonu görüldü. Mevcut bulgulardan yola çıkarak, insülin pompa kateterinin lokal mikro travma ile fiziksel uyaran oluşturduğu ve mastositoz lezyonlarının buna bağlı meydana geldiği düşünüldü. Pompa insülin tedavisi kesilip kateter uygulamasından vazgeçildi. İzleminde yeni lezyon çıkmadığı ve gluteal ve periumblikal bölgedeki lezyonların da hiperpigmentasyon ile düzeldiği görüldü. Doğrulama için yeniden insülin pompa kateteri takılan yerlerde 3 gün sonra aynı lezyonlar tekrarladı. Bu olgu nedeniyle, en az 48 saatlik süre boyunca cilt altında kalan kateterin, mastositozda lezyonları tetikleyebileceğini literatürde ilk defa ortaya koyduk. ABSTRACTMastocytosis is a relatively infrequent disorder characterized by mast cell proliferation within primarily the skin, but also various organs such as the bone marrow, liver, spleen, lymph nodes and the gastrointestinal system. Several factors are known to induce symptoms in patients with mastocytosis. A 13-year-old boy with cutaneous mastocytosis and type 1 diabetes mellitus developed multiple itchy papules 2 to 3 days after he started receiving insulin (lispro) pump therapy. Punch biopsy revealed widespread mast cell infiltration on the papillary dermis. We hypothesized that the insulin pump catheter caused a physical stimulus due to local microtrauma and resulted in the formation of the lesions. We, therefore, discontinued insulin pump treatment and switched to SC insulin therapy. While previous lesions healed successfully, no new lesions occurred. To confirm our hypothesis, we repeated the procedure and observed the occurrence of similar lesions around the insulin pump catheter. Herein, we present for the first time, a patient with type 1 diabetes mellitus and cutaneous mastocytosis who developed exacerbation of lesions during insulin pump therapy.Anahtar kelimeler: Mastositoz, kateter, tetikleyici

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Continuous subcutaneous insulin infusion (CSII) in the Veneto region: efficacy, acceptability and quality of life

Abstract: This retrospective analysis suggests that CSII improves metabolic control in Type 1 diabetic patients, reduces hypoglycaemic and ketoacidotic events, is well accepted, allows a good quality of life and decreases out-patient consultations and hospital admissions.

Cited by 78 publications

References 34 publications

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Short-Term Effects of Continuous Subcutaneous Insulin Infusion Therapy in Perioperative Patients with Diabetes Mellitus

Comparison of continuous subcutaneous insulin infusion and multiple daily insulin injections in Chinese patients with type 2 diabetes mellitus

An Unusual Trigger for Cutaneous Mastocytosis: The Insulin Pump

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