Statement by the American Association of Clinical Endocrinologists Consensus Panel on Insulin Pump Management

Grunberger, George; Bailey, Timothy S.; Cohen, A. Jay; Flood, Thomas M.; Handelsman, Yehuda; Hellman, Richard; Jovanovič, Lois; Moghissi, Etie S.; Orzeck, Eric A.

doi:10.4158/ep.16.5.746

Cited by 59 publications

(52 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…14,15 Experts may also recommend CSII for patients with T1DM who prefer pump therapy, as it may be more suitable to their lifestyle, regardless of the level of glycemic control, and in defined select patients with T2DM (e.g., C-peptide positive with suboptimal control on maximal program of basal/bolus injections, substantial dawn phenomenon, erratic lifestyle, or severe insulin resistance). 15 In the United States, the level of insulin pump usage has been estimated at 20% to 30% in patients with T1DM and less than 1% in patients with T2DM. 15,16 Blood Glucose-Monitoring Modalities There are currently several modalities available to assess and monitor blood glucose levels in diabetic patients.…”

Section: Approaches For Intensive Insulin Deliverymentioning

confidence: 99%

Methods for Insulin Delivery and Glucose Monitoring in Diabetes: Summary of a Comparative Effectiveness Review

Golden¹,

Sapir²

2012

JMCP

View full text Add to dashboard Cite

, before training in internal medicine and endocrinology and metabolism at the Johns Hopkins Hospital. During her fellowship in endocrinology, she received a master of health science degree in clinical epidemiology from the Johns Hopkins University Bloomberg School of Public Health. Her primary research interest centers around identifying endocrine risk factors associated with the development of diabetes and cardiovascular disease through the incorporation of measures of hormonal function into the design of clinical trials of cardiovascular risk modification, observational studies of incident cardiovascular disease and diabetes, and studies evaluating diabetic complications. Her current research focuses on studying the neuroendocrine response to chronic psychological stress as a risk factor for diabetes and cardiovascular disease. Dr Supplement Policy Statement Standards for Supplements to the Journal of Managed Care PharmacySupplements to the Journal of Managed Care Pharmacy are intended to support medical education and research in areas of clinical practice, health care quality improvement, or efficient administration and delivery of health benefits. The following standards are applied to all JMCP supplements to ensure quality and assist readers in evaluating potential bias and determining alternate explanations for findings and results. 1. Disclose the principal sources of funding in a manner that permits easy recognition by the reader. 2. Disclose the existence of all potential conflicts of interest among supplement contributors, including financial or personal bias. 3. Describe all drugs by generic name unless the use of the brand name is necessary to reduce the opportunity for confusion among readers. 4. Identify any off-label (unapproved) use by drug name and specific off-label indication. 5. Strive to report subjects of current interest to managed care pharmacists and other managed care professionals. S15 References Target AudiencesThis CME activity is designed to meet the educational needs of physicians, pharmacists, nurses, and case managers involved in the management and care of patients with diabetes. Learning ObjectivesBased on the findings from the Agency for Healthcare Research and Quality' s (AHRQ) comparative effectiveness review of insulin delivery and glucose-monitoring modalities for diabetes, participants should be able to: 1. Compare the benefits of insulin delivery systems in improving clinical outcomes, glycemic control, hypoglycemia, and quality of life in diabetic patients receiving intensive insulin therapy 2. Evaluate the differential effect of glucose-monitoring approaches on the process measures and intermediate and clinical outcomes in diabetic patients receiving intensive insulin therapy 3. Apply the AHRQ findings to guide effective, patient-centered clinical decisions Funding There is no fee for this CME/CE activity. This learning activity was prepared and funded under contract HHSA290201000006G from the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Hea...

show abstract

Section: Approaches For Intensive Insulin Deliverymentioning

confidence: 99%

Methods for Insulin Delivery and Glucose Monitoring in Diabetes: Summary of a Comparative Effectiveness Review

Golden¹,

Sapir²

2012

JMCP

View full text Add to dashboard Cite

show abstract

“…Some indications are a matter of personal choice (shift work, sports, or pregnancy planning). Hypoglycemic events are noted in all guidelines as a key indication for CSII therapy 6,14,19 . When taking this into consideration, it is no wonder that a diabetologist's personal judgment in most indications for CSII includes hypoglycemia.…”

Section: Discussionmentioning

confidence: 99%

“…dawn phenomenon, are candidates for continuous subcutaneous insulin infusion (CSII), e.g., insulin pumps. Those who exhibit allergy to prolonged acting insulin are also candidates for CSII 6 . There is no strict evidence that CSII treatment in pregnancy is superior to a multiple injection regimen in lowering hypoglycemia rates (lack of randomized trials).…”

Section: Introductionmentioning

confidence: 99%

Nocturnal Hypoglycemia – The Main Indication for Insulin Pump Therapy in Adulthood

Baretić

Kraljević

Renar

2016

ACC

View full text Add to dashboard Cite

SUMMARY -The aim was to determine which adult type 1 diabetic patient receiving multiple daily injection therapy is the most appropriate candidate for insulin pump therapy, while taking into consideration limited insulin pump affordability in Croatia. A total of 145 type 1 diabetic patients (52% diagnosed in adult age) were monitored at the Department of Endocrinology, Clinical Department of Internal Medicine, Zagreb University Hospital Center from 2009 to 2014. Twenty-one patients started insulin pump therapy in adulthood (seven men and 14 women, median age 27). Five patients had chronic complications (retinopathy in two, polyneuropathy in one, and both nephropathy and retinopathy in two patients). The median HbA1c at the initiation of pump therapy was 6.95% versus 6.5% after 1 year of pump therapy. Patients were stratified according to indications for insulin pump therapy (frequent and/or severe hypoglycemia, specific lifestyle, having not reached glycemic goals despite adherence/labile diabetes, and preconception). Patients could meet more than one criterion. Initially, the occurrence of hypoglycemia was analyzed by 6-day continuous glucose monitoring, while re-evaluation was done after collecting history data at 1 year ± 3 months. Initially, all patients had a median of 5 hypoglycemias/6 days (30% nocturnal) versus 1 hypoglycemia/6 days (without nocturnal) after 1 year. The Wilcoxon signed-rank test yielded a statistically significant difference in hypoglycemic events, nocturnal hypoglycemia and HbA1c. Patients commencing insulin pump therapy due to hypoglycemia initially had median HbA1c of 6.7% with 7 hypoglycemia/6 days (50% nocturnal). After one year, median HbA1c was 6% with 1 hypoglycemia/6 days (without nocturnal). In conclusion, the main indication for insulin pump therapy in adults is the frequency of hypoglycemia, especially nocturnal ones.

show abstract

“…As per American Association of Clinical Endocrinologists (AACE) insulin pump management task force, patients with type 1 DM who do not reach glycaemic goals despite adherence to a maximum MDI, are candidates for CSII (8), especially if they have:…”

Section: Guidelines Recommendationsmentioning

confidence: 99%

Continuous subcutaneous insulin infusion versus multiple dose insulin

Gupta

Kalra

2014

Sri Lanka J. Diabetes Endocrinol. Metab.

View full text Add to dashboard Cite

Statement by the American Association of Clinical Endocrinologists Consensus Panel on Insulin Pump Management

Cited by 59 publications

References 42 publications

Methods for Insulin Delivery and Glucose Monitoring in Diabetes: Summary of a Comparative Effectiveness Review

Methods for Insulin Delivery and Glucose Monitoring in Diabetes: Summary of a Comparative Effectiveness Review

Nocturnal Hypoglycemia – The Main Indication for Insulin Pump Therapy in Adulthood

Continuous subcutaneous insulin infusion versus multiple dose insulin

Contact Info

Product

Resources

About