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Insulin Pump Therapy

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https://www.readbyqxmd.com/read/28432898/cost-effectiveness-of-sensor-augmented-pump-therapy-versus-standard-insulin-pump-therapy-in-patients-with-type-1-diabetes-in-denmark
#1
S Roze, S de Portu, J Smith-Palmer, A Delbaere, W Valentine, M Ridderstråle
AIMS: The use of continuous subcutaneous insulin infusion (CSII) in type 1 diabetes (T1D) has increased in recent years. Sensor-augmented pump therapy (SAP) with low glucose suspend (LGS) (allowing temporary suspension of insulin delivery if blood glucose level falls below a pre-defined threshold level) provides additional benefits over CSII alone, but is associated with higher acquisition costs. Therefore, a cost-effectiveness analysis of SAP+LGS versus CSII in patients with T1D was performed...
February 16, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28430381/continuous-subcutaneous-insulin-infusion-csii-therapy-at-derby-teaching-hospitals-sustained-benefits-in-glucose-control
#2
U Anyanwagu, H Olaoye, P Jennings, S Ashton-Cleary, S Sugunendran, D Hughes, I Idris, E G Wilmot
AIM: In the short term, continuous subcutaneous insulin infusion (CSII) has been associated with improved glycaemic control, reduced hypoglycaemia and improved quality of life (QOL). However, limited data are available on its long-term benefits, particularly in the UK. We aimed to assess the impact of CSII on longer term outcomes. METHOD: Patient-level data were obtained for CSII users at Derby Teaching Hospitals, UK. Patient confidence and satisfaction questionnaires using the Likert scale were used to assess confidence in self-management...
April 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28425167/continuous-subcutaneous-insulin-infusion-special-needs-for-children
#3
REVIEW
Peter Adolfsson, Ralph Ziegler, Ragnar Hanas
Continuous subcutaneous insulin infusion (CSII) is a very common therapy for children with type 1 diabetes. Due to physiological differences they have other requirements for their insulin pump than adults. The main difference is the need for very low basal rates. Even though most available insulin pumps reach a high accuracy at usual basal rates, accuracy decreases for lower rates. In addition, the lowest delivered amount at 1 time is limiting the fine tuning of the basal rate as well as the option for temporary basal rates...
April 20, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28406034/analysis-of-a-new-optimized-percutaneous-access-system-for-cipii
#4
Eric Renard
While only used initially in cases with resistance to subcutaneous insulin therapy, intraperitoneal insulin therapy provides an overall more stable glucose control than subcutaneous insulin therapy thanks to its pharmacokinetics as pointed by Garcia-Verdugo et al from the experience of implantable insulin pumps. The expansion of these devices has been limited by underdelivery issues and high cost. The availability of a new percutaneous access to intraperitoneal route could allow a similar glucose control with less constraints of follow-up and expected lower cost...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28371223/faster-insulin-action-is-associated-with-improved-glycemic-outcomes-during-closed-loop-insulin-delivery-and-sensor-augmented-pump-therapy-in-adults-with-type-1-diabetes
#5
Yue Ruan, Hood Thabit, Lalantha Leelarathna, Sara Hartnell, Malgorzata E Willinska, Martin Tauschmann, Sibylle Dellweg, Carsten Benesch, Julia K Mader, Manuel Holzer, Harald Kojzar, Mark L Evans, Thomas R Pieber, Sabine Arnolds, Roman Hovorka
AIMS: To evaluate relationship between insulin pharmacodynamics and glycemic outcomes during closed-loop insulin delivery and sensor-augmented pump therapy. METHODS: We retrospectively analyzed data from multicenter randomized control trial involving 32 adults with type 1 diabetes receiving day-and-night closed-loop insulin delivery and sensor-augmented pump therapy over 12 weeks. We estimated time-to-peak insulin action (tmax,IA ) and insulin sensitivity (SI ) during both interventions and correlated these with demographic factors and glycemic outcomes...
March 30, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28367636/closing-the-loop-in-adults-children-and-adolescents-with-suboptimally-controlled-type-1-diabetes-under-free-living-conditions-a-psychosocial-substudy
#6
Katharine D Barnard, Timothy Wysocki, Vanessa Ully, Julia K Mader, Thomas R Pieber, Hood Thabit, Martin Tauschmann, Lalantha Leelarathna, Sara Hartnell, Carlo L Acerini, Malgorzata E Wilinska, Sibylle Dellweg, Carsten Benesch, Sabine Arnolds, Manuel Holzer, Harald Kojzar, Fiona Campbell, James Yong, Jennifer Pichierri, Peter Hindmarsh, Lutz Heinemann, Mark L Evans, Roman Hovorka
OBJECTIVE: The objective was to explore psychosocial experiences of closed loop technology for adults, children, and adolescents with type 1 diabetes and their parents taking part in two multicenter, free-living, randomized crossover home studies. METHODS: Participants using insulin pump therapy were randomized to either 12 weeks of automated closed-loop glucose control, then 12 weeks of sensor augmented insulin pump therapy (open loop), or vice versa. Closed loop was used for 24 hours by adults and overnight only by children and adolescents...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28367209/allergy-to-soft-cannula-of-insulin-pump-in-diabetic-patient
#7
Yu-Min Chen, Hui Huang
Insulin pump is a relatively good choice for diabetic patients who require multiple daily injections with wide fluctuations of blood glucose. Patients using insulin pump therapy and still having uncontrolled blood glucose levels for various factors: insulin pump not working properly, insulin instability, insulin autoantibody, insulin allergy, etc. We described a 46-year-old woman with type 2 diabetes and progressive hyperglycemia after switching multiple daily insulin injections to insulin pump, due to allergy to soft cannula of insulin pump...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28366258/-the-artificial-pancreas-a-dream-on-the-point-of-becoming-reality
#8
REVIEW
Éric Renard, Jérôme Place, Najib Benbrahim, Omar Diouri, Anne Farret
Almost 45 000 patients with type 1 diabetes are concerned in France by outpatient insulin pump therapy. The first systems of insulin pump therapy guided by glycaemia have evolved driven by the work carried out by multi-disciplinary research teams. Today, the outpatient treatment of type 1 diabetes by an artificial pancreas is on the point of becoming reality.
April 2017: Revue de L'infirmière
https://www.readbyqxmd.com/read/28366085/comparison-between-individually-and-group-based-insulin-pump-initiation-by-time-driven-activity-based-costing
#9
Martin Ridderstråle
BACKGROUND: Depending on available resources, competencies, and pedagogic preference, initiation of insulin pump therapy can be performed on either an individual or a group basis. Here we compared the two models with respect to resources used. METHODS: Time-driven activity-based costing (TDABC) was used to compare initiating insulin pump treatment in groups (GT) to individual treatment (IT). Activities and cost drivers were identified, timed, or estimated at location...
January 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28323942/incretin-therapies-do-not-expand-%C3%AE-cell-mass-or-alter-pancreatic-histology-in-young-male-mice
#10
Aaron R Cox, Carol J Lam, Matthew M Rankin, Jacqueline S Rios, Julia Chavez, Claire W Bonnyman, Kourtney B King, Roger A Wells, Deepti Anthony, Justin X Tu, Jenny J Kim, Changhong Li, Jake A Kushner
The impact of incretins upon pancreatic β-cell expansion remains extremely controversial. Multiple studies indicate that incretin-based therapies can increase β-cell proliferation, and incretins have been hypothesized to expand β-cell mass. However, considerable disagreement exists on whether incretins actually increase β-cell mass. Moreover, some reports indicate that incretins may cause metaplastic changes in pancreatic histology. To resolve these questions we treated a large cohort of mice with incretin-based therapies and carried out a rigorous analysis of β-cell turnover and pancreatic histology using high-throughput imaging...
March 8, 2017: Endocrinology
https://www.readbyqxmd.com/read/28322429/treatment-challenges-in-type-1-diabetes-after-roux-en-y-gastric-bypass
#11
Lucie Favre, François Pralong, Michel Suter, François R Jornayvaz
Bariatric surgery is an effective treatment of type 2 diabetes in obese patients. The obesity epidemic does not spare patients with type 1 diabetes mellitus (T1DM), but there is no consensus regarding the role of surgery in the management of obese T1DM patients. Published data consistently report significant weight loss after surgery in obese T1DM patients, but long-term glycaemic control remains difficult to achieve. Here we present our experience with a challenging patient and a review of the literature. Our patient successfully underwent a roux-en-Y gastric bypass (RYGB) when she was 28 years old...
March 21, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28322157/diabetes-related-neurological-implications-and-pharmacogenomics
#12
Rojas Carranza Camilo Andrés, Bustos Cruz Rosa Helena, Pino Pinzón Carmen Juliana, Ariza Marquez Yeimy Viviana, Gómez Bello Rosa Margarita, Cañadas Garre Marisa
Diabetes mellitus (DM) is the most commonly occurring cause of neuropathy around the world and is beginning to grow in countries where there is a risk of obesity. DM Type II, (T2DM) is a common age-related disease and is a major health concern, particularly in developed countries in Europe where the population is aging. T2DM is a chronic disease which is characterised by hyperglycemia, hyperinsulinemia and insulin resistance, together with the body's inability to use glucose as energy. Such metabolic disorder produces a chronic inflammatory state, as well as changes in lipid metabolism leading to hypertriglyceridemia, thereby producing chronic deterioration of the organs and premature morbidity and mortality...
March 17, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28321303/comparative-study-on-treatment-satisfaction-and-health-perception-in-children-and-adolescents-with-type-1-diabetes-mellitus-on-multiple-daily-injection-of-insulin-insulin-pump-and-sensor-augmented-pump-therapy
#13
Tara Hussain, Mariette Akle, Nico Nagelkerke, Asma Deeb
OBJECTIVES: Diabetes management imposes considerable demands on patients. Treatment method used has an impact on treatment satisfaction. We aim to examine the relationship between treatment satisfaction and health perception with the method used for treatment of type 1 diabetes mellitus in children and adolescents. SUBJECTS AND METHOD: We have interviewed patients with type 1 diabetes mellitus using questionnaires to assess treatment satisfaction and health perception...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28296467/comparison-of-insulin-pump-therapy-and-multiple-daily-injections-insulin-regimen-in-patients-with-type-1-diabetes-during-ramadan-fasting
#14
Reem Alamoudi, Maram Alsubaiee, Ali Alqarni, Yousef Saleh, Saleh Aljaser, Abdul Salam, Mohsen Eledrisi
INTRODUCTION: Fasting Ramadan carries a high risk for patients with type 1 diabetes (T1DM). Data on the optimum insulin regimen in these patients are limited. OBJECTIVES: To compare glucose profiles in patients with T1DM who use continuous subcutaneous insulin infusion (CSII) compared with those who use multiple daily injections (MDI) insulin regimen during Ramadan fast. The primary outcome was rates of hypoglycemia. Other outcomes included glycemic control, number of days needed to break fasting, and acute glycemic complications...
March 15, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28289908/why-should-people-with-type-1-diabetes-exercise-regularly
#15
Roberto Codella, Ileana Terruzzi, Livio Luzi
Plethoric evidence reminds of the protective effects of exercise against a number of health risks, across all ages, in the general population. The benefits of exercise for individuals with type 2 diabetes are indisputable. An in-depth understanding of energy metabolism has reasonably entailed exercise as a cornerstone in the lifestyle of almost all subjects with type 1 diabetes. Nevertheless, individuals with type 1 diabetes often fail in accomplishing exercise guidelines and they are less active than their peer without diabetes...
March 14, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28268372/evaluation-of-a-novel-portable-micro-pump-and-infusion-system-for-drug-delivery
#16
Paul Pankhurst, Zahra McGuinness Abdollahi
In this paper the design, fabrication and experimental results of a novel portable fixed-displacement micro-pump for controlled dosing and timing is described. The new pump is developed especially for high efficiency, high accuracy, ease of use and very low cost for single use drug delivery systems which can overcome many of the deficiencies of current portable pumps. Primary tests have been conducted and the results have demonstrated that the pump has the ability to deliver high performance and accuracy with less than +/-1% error over the whole operating flow rate range of 0...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28264604/maternal-and-perinatal-outcomes-in-pregnant-women-with-type-1-diabetes-treated-with-continuous-subcutaneous-insulin-infusion-and-real-time-continuous-glucose-monitoring-in-two-specialized-centers-in-medellin-colombia
#17
Mónica Restrepo-Moreno, Alex Ramírez-Rincón, Jaime Hincapié-García, Andrés Palacio, Claudia Monsalve-Arango, Natalia Aristizabal-Henao, Camila Restrepo-Zapata, José Fernando Botero-Arango
OBJECTIVE: We assessed maternal and perinatal outcomes in pregnant women with type 1 diabetes, treated with continuous subcutaneous insulin infusion and real time continuous glucose monitoring. METHODS: This is a retrospective study, analyzing the basal characteristics, glycemic control, maternal and perinatal outcomes of pregnant women with type 1 diabetes, who were on an insulin pump with continuous glucose monitoring between 2011 and 2015. RESULTS: Fourteen patients were included...
March 6, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28264177/a-randomized-controlled-study-of-an-insulin-dosing-application-that-uses-recognition-and-meal-bolus-estimations
#18
Ewa Pańkowska, Piotr Ładyżyński, Piotr Foltyński, Karolina Mazurczak
BACKGROUND: Throughout the insulin pump therapy, decisions of prandial boluses programming are taken by patients individually a few times every day, and, moreover, this complex process requires numerical skills and knowledge in nutrition components estimation. The aim of the study was to determine the impact of the expert system, supporting the patient's decision on meal bolus programming, on the time in range of diurnal glucose excursion in patients treated with continuous subcutaneous insulin infusion (CSII)...
January 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28264176/the-first-use-of-bolus-calculator-with-speech-analyzer
#19
Karolina Mazurczak, Ewa Pańkowska, Piotr Ładyżyński, Piotr Foltyński
BACKGROUND: The insulin therapy in type 1 diabetes involves a wide array of restrictions in patients and their families. One of those is a difficulty in estimation of the insulin dose programmed for each meal. The purpose of the study is an assessment of functionalities related to the expert system VoiceDiab-a calculator of meal boluses. METHODS: The sample group composed of 54 patients, aged 3-52, all suffering from type 1 diabetes, treated with the insulin pump, taking part in the clinics RCT (for adults and a pediatrician), with a randomized allocation to a surveyed group and cross-over...
January 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28260302/-insulin-regimes-and-impact-on-glycemic-control-in-patients-with-type-1-diabetes
#20
J H Yan, Y Zhang, X Y Zheng, S H Luo, H Y Ai, J Lü, L L Qiu, X W Zhang, D Z Yang, B Yao, J P Weng
Objective: To describe the insulin regimens and their associations with glycemic control and to explore factors associated with intensive insulin therapy. Methods: Patients with type 1 diabetes (T1DM) were recruited from Guangdong Type 1 Diabetes Mellitus Translational Medicine Study which was conducted in 16 centers in Guangdong province. The demographic and clinical data were collected. Patients were grouped according to different insulin regimens: insulin pump (R1), basal insulin plus regular insulin or short-acting insulin (R2), insulin injection 1-3 times per day (R3)...
February 28, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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