Factors affecting improved glycaemic control in youth using insulin pumps

Wilkinson, Jane; McFann, Kim; Chase, H. Peter

doi:10.1111/j.1464-5491.2010.03068.x

Cited by 26 publications

(44 citation statements)

References 10 publications

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“…Likewise, Shalitin et al showed that only toddlers continued to decrease the HbA 1c level even after three years [8]. We found that age showed a significant negative correlation with the daily number of boluses and SMBG's in accordance with Wilkinson et al [25] (Table 3). Another finding was a significant difference in the amount of pubertal and prepubertal children among the responder and non-responders at 24 months follow-up.…”

Section: Discussionsupporting

confidence: 92%

Characterization of metabolic responders on CSII treatment amongst children and adolescents in Denmark from 2007 to 2013

Ingeholm

Svensson

Olsen

et al. 2015

Diabetes Research and Clinical Practice

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Section: Discussionsupporting

confidence: 92%

Characterization of metabolic responders on CSII treatment amongst children and adolescents in Denmark from 2007 to 2013

Ingeholm

Svensson

Olsen

et al. 2015

Diabetes Research and Clinical Practice

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“…23 The use of other pump options such as the temporary basal rate also provides an improvement in HbA1c levels. 24 Seasonal switch to MDI concerned only 10% of our cohort. These switches were usually of 1-month duration and did not exceed 2 months, therefore explaining the lack of glucose control impairment associated with seasonal switch.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional Survey and Retrospective Analysis of a Large Cohort of Adults With Type 1 Diabetes With Long-Term Continuous Subcutaneous Insulin Infusion Treatment

Joubert

Morera

Vicente

et al. 2014

J Diabetes Sci Technol

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Continuous subcutaneous insulin infusion (CSII) is an established modality for treating type 1 diabetes (T1D) when the HbA1c level persistently remains above 7.5% despite the intensification of health care by a multidisciplinary team and optimization of the patient's education.1 When compared to multiple daily injections (MDI), CSII allows an equal or lower HbA1c level with fewer mild and severe cases of hypoglycemia.2-5 Most studies on CSII utilization in T1D were prospective and were conducted from several weeks' to 2 years' duration.2 Few retrospective studies have questioned the long-term benefit of CSII utilization, and long-term evaluations of satisfaction and quality of life are scarce.6-13 The present cross-sectional survey and retrospective analysis of a cohort of patients with T1D treated by CSII gives the opportunity to evaluate the long-term tolerance and satisfaction of the device and the therapeutic behavior of CSII users in reallife conditions. Safety and efficacy issues are also under the scope of this study. MethodsThis single-center retrospective study and trans-sectional survey was conducted by the endocrinology department from a French university hospital. The study enrolled patients with T1D using CSII for more than 1 year from January 1999 (year of reimbursement of CSII treatment by the French National Health System) until December 2008. Insulin pumps used in our center during this period of time were Medtronic 508, 511, 512, and 515 (Medtronic, Minneapolis, AbstractBackground. Continuous subcutaneous insulin infusion (CSII) is an established modality for intensive insulin treatment of type 1 diabetes (T1D), but long-term data concerning satisfaction, CSII function use, safety, and efficacy in real-life conditions are scarce. Methods. We analyzed a cohort of adult patients with T1D treated with CSII for more than 1 year in a single diabetes center. We performed a cross-sectional survey in 2010 (tolerance/satisfaction and behavior forms) and a retrospective analysis of medical records (including HbA1c level, hospitalization, and catheter infections). The primary objective was to assess long-term tolerance/satisfaction, and secondary objectives were safety and efficacy. Results. There were 295 patients analyzed. After a median duration of CSII use of 5 years, overall satisfaction was high for about 90% of patients. Mean CSIIrelated discomfort scores were low for work, recreation, and sleep and moderate for sport and sexual activity (2.5 ± 1.9, 2.6 ± 1.8, 2.6 ± 2.1, 3.4 ± 2.3, and 4.0 ± 2.9 of 10, respectively). Despite a high level of diabetes education, only one third of patients were using advanced CSII functions. During long-term follow-up, the safety of CSII treatment was good; the hospitalization rate was 0.18 patients/year, and catheter infections were scarce. The HbA1c level dropped about -0.5% independently from CSII duration (P < .05). Conclusions. In this adult cohort, satisfaction and tolerance, together with safety, of CSII were maintained at long-term follow up. The sole basic f...

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“…We recently evaluated factors related to improvement in hemoglobin A1c (HbA1c) levels in youth using an insulin pump. 11 The more frequent use of temporary basal rates was the number one factor relating to improvement in the HbA1c level. (Admittedly, this may just be a reflection of paying closer attention to the person's diabetes.)…”

Section: Temporary Basal Ratesmentioning

confidence: 99%

The Use of Insulin Pumps in Youth with Type 1 Diabetes

Maahs¹,

Horton²,

Chase³

2010

Diabetes Technology & Therapeutics

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The use of insulin pump therapy (continuous subcutaneous insulin infusion) has increased dramatically in youth with type 1 diabetes (T1D) in the past decade. In this review we provide background and practical clinical advice on insulin basal rates and bolus doses and on the advantages of pump therapy with exercise. Acute complications of T1D (hypoglycemia and diabetic ketoacidosis) in the context of pump therapy are reviewed. The advantages of pump therapy in the school setting and in hospitalized patients are discussed. Finally, diabetes management in the 21 st century, in which pump therapy is combined with continuous glucose monitoring, and its potential for a closed-loop pancreas are presented.

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Factors affecting improved glycaemic control in youth using insulin pumps

Abstract: This study emphasizes the importance of blood glucose testing, of bolus insulin administration and of an increase in the time of temporary basal rate use in relation to improving glycaemic control.

Cited by 26 publications

References 10 publications

Characterization of metabolic responders on CSII treatment amongst children and adolescents in Denmark from 2007 to 2013

Characterization of metabolic responders on CSII treatment amongst children and adolescents in Denmark from 2007 to 2013

Cross-sectional Survey and Retrospective Analysis of a Large Cohort of Adults With Type 1 Diabetes With Long-Term Continuous Subcutaneous Insulin Infusion Treatment

The Use of Insulin Pumps in Youth with Type 1 Diabetes

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