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Metabolic control with insulin pump therapy: the Waikato experience.
N Z Med J. 2007 Jan 26; 120(1248):U2401.NZ

Abstract

AIM

To report the effect of insulin pump therapy on glycaemic control and on hypoglycaemia and ketosis rates in Type 1 diabetic patients.

METHODS

A retrospective audit of the management of patients with Type 1 diabetes treated with insulin pump therapy at the Waikato Diabetes Service (Hamilton, New Zealand) between September 1997 and December 2004.

RESULTS

The data of 105 patients currently on continuous subcutaneous insulin infusion (CSII) at the time of data collection were examined. CSII use had occurred for a mean of 3.0+/-2.6 years. HbA1c% improved significantly from 8.9+/-1.3% to 7.9+/-1.0% (P<0.001) at 3 months and 7.9+/-0.95% (P<0.001) at 6 months post CSII. This reduction was maintained after 1, 2, and 3 years and the difference was statistically significant (P<0.001). In the adolescent subgroup (n=27) we observed a similar significant reduction in HbA1c% that was maintained after 1 year of pump therapy. The incidence of severe hypoglycaemia was reduced from 0.75 cases per patient-year during multiple daily injection (MDI) pre-pump to 0.05 cases per patient-year during CSII (P<0.001). In some cases hypoglycaemia awareness was restored. There was no evidence to suggest increased tendency for diabetic ketoacidosis (DKA) with continuing use of insulin pumps. Conclusion Our experience showed that insulin pump therapy was effective and safe for both adults and adolescents with Type 1 diabetes. The reduction in HbA1c% was both statistically and clinically highly significant. Wider usage of this technology in New Zealand is warranted.

Authors+Show Affiliations

Department of Diabetes and Endocrinology, Waikato Hospital, Hamilton. RedaE@waikatodhb.govt.nzNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17277817

Citation

Reda, Elham, et al. "Metabolic Control With Insulin Pump Therapy: the Waikato Experience." The New Zealand Medical Journal, vol. 120, no. 1248, 2007, pp. U2401.
Reda E, Von Reitzenstein A, Dunn P. Metabolic control with insulin pump therapy: the Waikato experience. N Z Med J. 2007;120(1248):U2401.
Reda, E., Von Reitzenstein, A., & Dunn, P. (2007). Metabolic control with insulin pump therapy: the Waikato experience. The New Zealand Medical Journal, 120(1248), U2401.
Reda E, Von Reitzenstein A, Dunn P. Metabolic Control With Insulin Pump Therapy: the Waikato Experience. N Z Med J. 2007 Jan 26;120(1248):U2401. PubMed PMID: 17277817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic control with insulin pump therapy: the Waikato experience. AU - Reda,Elham, AU - Von Reitzenstein,Angelica, AU - Dunn,Peter, Y1 - 2007/01/26/ PY - 2007/2/6/pubmed PY - 2007/2/9/medline PY - 2007/2/6/entrez SP - U2401 EP - U2401 JF - The New Zealand medical journal JO - N Z Med J VL - 120 IS - 1248 N2 - AIM: To report the effect of insulin pump therapy on glycaemic control and on hypoglycaemia and ketosis rates in Type 1 diabetic patients. METHODS: A retrospective audit of the management of patients with Type 1 diabetes treated with insulin pump therapy at the Waikato Diabetes Service (Hamilton, New Zealand) between September 1997 and December 2004. RESULTS: The data of 105 patients currently on continuous subcutaneous insulin infusion (CSII) at the time of data collection were examined. CSII use had occurred for a mean of 3.0+/-2.6 years. HbA1c% improved significantly from 8.9+/-1.3% to 7.9+/-1.0% (P<0.001) at 3 months and 7.9+/-0.95% (P<0.001) at 6 months post CSII. This reduction was maintained after 1, 2, and 3 years and the difference was statistically significant (P<0.001). In the adolescent subgroup (n=27) we observed a similar significant reduction in HbA1c% that was maintained after 1 year of pump therapy. The incidence of severe hypoglycaemia was reduced from 0.75 cases per patient-year during multiple daily injection (MDI) pre-pump to 0.05 cases per patient-year during CSII (P<0.001). In some cases hypoglycaemia awareness was restored. There was no evidence to suggest increased tendency for diabetic ketoacidosis (DKA) with continuing use of insulin pumps. Conclusion Our experience showed that insulin pump therapy was effective and safe for both adults and adolescents with Type 1 diabetes. The reduction in HbA1c% was both statistically and clinically highly significant. Wider usage of this technology in New Zealand is warranted. SN - 1175-8716 UR - https://www.unboundmedicine.com/medline/citation/17277817/Metabolic_control_with_insulin_pump_therapy:_the_Waikato_experience_ DB - PRIME DP - Unbound Medicine ER -