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External insulin pump treatment in the day-to-day management of diabetes: benefits and future prospectives.
Diabetes Metab. 2011 Dec; 37 Suppl 4:S40-7.DM

Abstract

The aim of diabetes treatment is to achieve tight glucose control to avoid the development of chronic diabetes complications while reducing the frequency of hypoglycaemic episodes. The main clinical indications of pump therapy in type 1 diabetes are persistently elevated HbA(1c) in spite of the best attempts of intensified insulin therapy with multiple daily injections (MDI) and/or frequent, disabling or severe hypoglycaemia. Several trials have demonstrated the superiority of continuous subcutaneous insulin infusion (CSII) over MDI, and highlighted the benefits of using short-acting insulin analogues. However, new MDI regimens with long-acting insulin analogues challenge insulin pump therapy in some indications, thus indicating the need for precise selection of those patients who will benefit the most from CSII. In type 2 diabetes, pump therapy may be an invaluable tool in selected patients characterized by chronic elevation of HbA(1c), obesity and high insulin requirements. In addition, in any case, specific education, training and ongoing evaluation of the benefit/risk ratio of the treatment are mandatory. Furthermore, there is continuing progress in the development of pump and catheter features, and insulin kinetics can still be improved. These technical advances are part of the work in progress towards developing closed-loop systems.

Authors+Show Affiliations

Service de Diabétologie, Maladies Métaboliques et Nutrition, pôle cardiovasculaire et métabolique, CHU de Toulouse, Université de Toulouse, Toulouse, France. hanaire.h@chu-toulouse.fr

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22208709

Citation

Hanaire, H. "External Insulin Pump Treatment in the Day-to-day Management of Diabetes: Benefits and Future Prospectives." Diabetes & Metabolism, vol. 37 Suppl 4, 2011, pp. S40-7.
Hanaire H. External insulin pump treatment in the day-to-day management of diabetes: benefits and future prospectives. Diabetes Metab. 2011;37 Suppl 4:S40-7.
Hanaire, H. (2011). External insulin pump treatment in the day-to-day management of diabetes: benefits and future prospectives. Diabetes & Metabolism, 37 Suppl 4, S40-7. https://doi.org/10.1016/S1262-3636(11)70964-8
Hanaire H. External Insulin Pump Treatment in the Day-to-day Management of Diabetes: Benefits and Future Prospectives. Diabetes Metab. 2011;37 Suppl 4:S40-7. PubMed PMID: 22208709.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - External insulin pump treatment in the day-to-day management of diabetes: benefits and future prospectives. A1 - Hanaire,H, PY - 2012/1/3/entrez PY - 2012/1/3/pubmed PY - 2012/6/8/medline SP - S40 EP - 7 JF - Diabetes & metabolism JO - Diabetes Metab VL - 37 Suppl 4 N2 - The aim of diabetes treatment is to achieve tight glucose control to avoid the development of chronic diabetes complications while reducing the frequency of hypoglycaemic episodes. The main clinical indications of pump therapy in type 1 diabetes are persistently elevated HbA(1c) in spite of the best attempts of intensified insulin therapy with multiple daily injections (MDI) and/or frequent, disabling or severe hypoglycaemia. Several trials have demonstrated the superiority of continuous subcutaneous insulin infusion (CSII) over MDI, and highlighted the benefits of using short-acting insulin analogues. However, new MDI regimens with long-acting insulin analogues challenge insulin pump therapy in some indications, thus indicating the need for precise selection of those patients who will benefit the most from CSII. In type 2 diabetes, pump therapy may be an invaluable tool in selected patients characterized by chronic elevation of HbA(1c), obesity and high insulin requirements. In addition, in any case, specific education, training and ongoing evaluation of the benefit/risk ratio of the treatment are mandatory. Furthermore, there is continuing progress in the development of pump and catheter features, and insulin kinetics can still be improved. These technical advances are part of the work in progress towards developing closed-loop systems. SN - 1878-1780 UR - https://www.unboundmedicine.com/medline/citation/22208709/External_insulin_pump_treatment_in_the_day_to_day_management_of_diabetes:_benefits_and_future_prospectives_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1262-3636(11)70964-8 DB - PRIME DP - Unbound Medicine ER -