Evaluation of insulin pump treatment under routine conditions

Rønn, Birgitte; Mathiesen, E. R.; Vang, Linda Matasic; Lørup, B.; Deckert, T.

doi:10.1016/s0168-8227(87)80038-4

Cited by 33 publications

(18 citation statements)

References 11 publications

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“…Seven studies (19,35,44,46,51,56,82) asked subjects to describe their perceptions about the advantages of CSII therapy. The most common response was improved flexibility.…”

Section: Descriptive Datamentioning

confidence: 99%

Insulin Pump Therapy

2003

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OBJECTIVE -To conduct a meta-analysis of the metabolic and psychosocial impact of continuous subcutaneous insulin infusion (CSII) therapy on adults, adolescents, and children.RESEARCH DESIGN AND METHODS -Studies were identified and data regarding study design, year of publication, sample size, patient's age, diabetes duration, and duration of CSII therapy were collected. Means and SDs for glycohemoglobin, blood glucose, insulin dosages, and body weight for CSII and comparison conditions were subjected to meta-analytic procedures. Data regarding pump complications and psychosocial functioning were reviewed descriptively.RESULTS -A total of 52 studies, consisting of 1,547 patients, were included in the metaanalysis. Results indicate that CSII therapy is associated with significant improvements in glycemic control (decreased glycohemoglobin and mean blood glucose). A descriptive review of potential complications of CSII use (e.g., hypoglycemia, diabetic ketoacidosis [DKA], pump malfunction, and site infections) suggests a decreased frequency of hypoglycemic episodes but an increased frequency of DKA in studies published before 1993.CONCLUSIONS -CSII therapy is associated with improved glycemic control compared with traditional insulin therapies (conventional therapy and multiple daily injections) and does not appear to be associated with significant adverse outcomes. Additional studies are needed to further examine the relative risks of CSII therapy, including the potential psychosocial impact of this technologically advanced therapy.

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“…Seven studies (19,35,44,46,51,56,82) asked subjects to describe their perceptions about the advantages of CSII therapy. The most common response was improved flexibility.…”

Section: Descriptive Datamentioning

confidence: 99%

Insulin Pump Therapy

2003

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“…Findings comparing insulin pump use to multiple daily injections varied with regard to depressive symptoms (7)(8)(9) and quality of life (5,6,8,10) but did not differ in relation to anxiety (7)(8)(9), self-esteem (9), and locus of control (7). Studies exploring subjects' perceptions of advantages of insulin pumps reported increased flexibility, greater freedom, greater ease with meals, decreased physical complaints, decreased sense of physical restriction, and improved glycemic control (11)(12)(13)(14)(15). One recent study (3) found no difference in quality of life between insulin pump users and those using multiple daily injections.…”

mentioning

confidence: 99%

Perceptions of Psychosocial Factors and the Insulin Pump

et al. 2007

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OBJECTIVE -The purpose of this study was to identify psychosocial issues related to diabetes, approaches to self-care, self-perceptions, and social interactions among insulin pump users with type 1 diabetes.RESEARCH DESIGN AND METHODS -Adult insulin pump users participated in focus groups loosely formed on the basis of A1C level. Transcripts of focus group meetings were coded into themes by five reviewers using NVivo2 qualitative software.RESULTS -Thirty adults with long-term diabetes participated in five focus groups: two with low mean ϮSD A1C (6.8 Ϯ 0.4%), one with mid A1C (7.80 Ϯ 0.3%), and two with high A1C (9.1 Ϯ 0.5%). Three major themes were identified: impact on diabetes self-care, emotional reactions to the insulin pump, body image, and social acceptance. Participants who described the pump as a tool to meet glycemic goals also described a more active approach to diabetes and had better glycemic control; those who discussed the pump as a panacea described more passive self-care and had poorer glycemic control. Low A1C groups reported that starting the insulin pump reminded them of feelings they experienced at their initial diabetes diagnosis, whereas the high A1C groups did not report these feelings. Women were more concerned than men about body image and social acceptance with pump use. CONCLUSIONS -Active participation in self-care, realistic expectations of pump use, and emotional recall of diabetes diagnosis were associated with better glycemic control. Interventions to improve diabetes management with pump use should include evaluation and discussion of active versus passive approaches to self-care, recall of diabetes diagnosis, expectations of the pump, and pump-related self-consciousness and body image concerns. The roles of these factors in optimal diabetes management warrant further investigation. Diabetes Care 30:549 -554, 2007

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“…A redução no valor absoluto médio da HbA 1 c foi de 1,78%. Os nossos resultados comparam-se a de outros previamente publicados e que demonstraram uma redução da hemoglobina glicosilada de 1 a 3,4% (9,(12)(13)(14). Se considerarmos os dados do DCCT sob o declínio do valor absoluto da hemoglobina glicosilada de 1%, poderemos estimar que mantendo-se essa meta, os nossos pacientes se beneficiarão com uma redução de pelo menos 43% no risco de retinopatia, 48% de nefropatia e 38% de neuropatia (16).…”

Section: Discussionunclassified

Tratamento do diabetes mellitus tipo 1 com bomba de infusão subcutânea contínua de insulina e insulina lispro

Hissa

Bruin

2001

Arq Bras Endocrinol Metab

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RESUMOObjetivo: Avaliar a eficácia do tratamento do diabetes mellitus tipo 1 por um período de 18 meses, em 17 pacientes, utilizando-se um processo de infusão subcutânea contínua de insulina (ISCI) e de um análogo da insulina (insulina lispro) através de uma bomba infusora. Estudamos os seguintes parâmetros: hemoglobina glicosilada, peso, índice de massa corpórea, relação insulina/peso, quantidade de insulina/dia administrada, relação da insulina administrada na forma de bolus (antes das refeições) com a insulina basal e efeitos adversos desta terapia. Após esse período observamos que os pacientes estavam melhor controlados com níveis de HbA1c significativamente reduzidos (p< 0,05). Apresentavam uma redução significativa da relação insulina/peso (p< 0,05) e melhor aproveitamento da insulina relacionado a alimentação dado pelo aumento significativo da relação bolus/basal quando comparado com a relação de insulina regular/NPH antes do tratamento (p< 0,05). ABSTRACTObjective: To evaluate the treatment efficacy of type 1 diabetes mellitus during 18 months with a continuous subcutaneous insulin infusion pump and insulin lispro. The following paramethers were studied: glycosylated hemoglobin, weight, body mass index, amount of insulin administered daily, ratio between daily insulin dose and weight, ratio between insulin administered as bolus and as basal and the colateral effects of this form of therapy. After 18 months the patients were in better diabetic control with a significant lower level of glycosylated hemoglobin (p< 0.05). They presented a significant reduction in the ratio between insulin daily dose and weight (p< 0.05) and a better utilization of insulin related to meal observed by the significant rise in the ratio between insulin administered as bolus and as basal when compared with the ratio of regular and NPH before the SCII treatment (p< 0.05).

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Evaluation of insulin pump treatment under routine conditions

Cited by 33 publications

References 11 publications

Insulin Pump Therapy

Insulin Pump Therapy

Perceptions of Psychosocial Factors and the Insulin Pump

Tratamento do diabetes mellitus tipo 1 com bomba de infusão subcutânea contínua de insulina e insulina lispro

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