Management of type 1 and type 2 diabetes requiring insulin

Background: Although, number of diabetic patients received insulin pump (IP) therapy is increasing; there are limited data regarding factors associated with IP withdrawal.Methods: We conducted a cross-sectional study using data from an Israeli health maintenance organization. All patients, 21 or older, with type 1 (T1DM) or type 2 (T2DM) diabetes, who received IP therapy for a 7-year period were identified.Patients who did not purchase IP maintenance supplies for at least six consecutive months were defined as withdrawn (N = 355). Patients who purchased supplies were defined as adherent (N = 352). Results: In both T1DM and T2DM patients, withdrawal from IP therapy was positively associated with duration of diabetes longer than 5 years (odds ratio [OR] = 13.26 [CI, 7.16-23.34; P < .001] and OR = 10.92 [CI, 5.64-21.14; P < .001], respectively), nonadherence to dietician follow-up (OR = 5.78 [CI, 3.65-9.14; P < .001] and OR = 3.41 [CI, 1.99-5.85; P < .001], respectively), and poor glycaemic control prior to IP treatment (OR = 4.04 [CI, 2.18-7.48; P < .001] and OR = 4.59 [CI, 2.71-7.81; P < .001], respectively]. Co-morbid neuro-psychiatric disorders were also risk factors for IP withdrawal: diagnosis of depression (OR = 2.22 [CI, 1.16-4.27; P = .017] and Attention Deficit Hyperactivity Disorder (ADHD) OR = 2.45 [CI, 1.003-5.087; P = .043]) among T1DM patients; and diagnosis of depression (OR = 1.85 [CI, 1.05-5.27; P = .046] and dementia OR = 4.03 [CI, 1.03-19.77; P = .048]) among T2DM patients. Conclusion: In our large real-world population-based study, we found that smoking, obesity, poor glycaemic control, and co-morbid neuro-psychiatric disorders were associated with a high rate of withdrawal from IP therapy. Health care providers ought to familiarize themselves with patient characteristics predictive of nonadherence and should intensify patient follow-up when incorporating this new, costly, and challenging technology. K E Y W O R D S diabetes mellitus, insulin pump, nonadherence

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“…Interestingly, our study did not establish a significant association between age or low socioeconomic status to IP withdrawal …”

Section: Discussioncontrasting

confidence: 93%

Factors associated with withdrawal from insulin pump therapy: A large‐population‐based study

Merzon

Grossman

Vinker

et al. 2020

Diabetes Metabolism Res

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“…T1D is an autoimmune metabolic disorder that destroys the insulin-producing beta cells in the pancreas, resulting in the absence of insulin in the body (Abiola et al, 2016). Because the pancreas is unable to produce insulin, individuals are dependent on a regimen of exogenous insulin to maintain blood glucose control.…”

Section: T1d and T2dmentioning

confidence: 99%

“…People living with T1D are often prescribed two different types of insulin characterized by their onset and duration of action: short-acting (bolus) or long-acting (basal). Bolus insulin is administered for immediate control of blood glucose levels (e.g., at meals or in response to a high blood glucose reading), whereas basal insulin is administered once or twice daily to mimic the background secretion of insulin in an individual without T1D as closely as possible (Abiola et al, 2016). The Centers for Disease Control and Prevention (CDC, 2020b) report that of the 34.2 million people living with either T1D or T2D in the United States, only 5% to 10% of these people are living with T1D.…”

Section: T1d and T2dmentioning

confidence: 99%

“…T2D is a metabolic disorder under which either the pancreas secretes an inadequate amount of insulin or insulin-responsive cells cannot use the insulin that is produced properly (insulin resistance), resulting in poor blood glucose control. Oral medications such as Metformin are often prescribed to those living with T2D (along with suggestions for weight loss, healthy eating habits, and physical activity) before resorting to insulin therapy (Abiola et al, 2016; CDC, 2020b; Inzucchi et al, 2014). Diagnoses of T2D make up between 90% and 95% of diabetes diagnoses in the United States (CDC, 2020b).…”

Section: T1d and T2dmentioning

confidence: 99%

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Integrating Illness Management Into Identity Verification Processes

Maietta

2020

Qual Health Res

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Individuals living with type 1 diabetes (T1D) or type 2 diabetes (T2D) can experience conflict between self-presentation and their symptoms or management regimens. In this article, I explain how these individuals might use their illness management techniques to aid in successfully self-presenting or having their identities verified. Interview respondents associate conflicts brought on by symptoms or management regimens with identity processes and report some instances when illness management enables them to successfully perform identities. Researchers have previously found ways that individuals work to renegotiate or preserve their identities by suppressing or hiding their illnesses. I additionally highlight instances where individuals embrace illness management to successfully perform identities, a process I call integrating illness management into the identity verification process. The importance of research on access to illness management tools and education is emphasized, as researchers aid individuals not only in maintaining good health but also being their best social selves.

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“…It is done in the morning. Patients with FBG greater than 125mg/dl (11 mMol/L) are considered diabetic [2]. The management of diabetes mellitus is approached pharmacologically and non-pharmacologically.…”

Section: Introductionmentioning

confidence: 99%

Rhizome extract of Curcuma domestica L. (Zingiberacae) in Alloxan- induced diabetic rats

Sunday

Emmanuel

Effiong

2020

GSC Biol. and Pharm. Sci.

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Diabetes mellitus is a serious health problem in Nigeria. This study evaluated the anti-diabetic potential of Curcuma domestica in alloxam induced diabetes in albino wistar rats. In Akwa Ibom State, Nigeria the rhizome of Curcuma domestia is used in traditional medicine to expel worms from the gastrointestinal tract, relieve indigestion and frequent urination. It is also used to treat skin diseases, pains in the joints, knee, hips and spine. Rhizome of C. domestica was extracted using the cold solvent process. Diabetes was induced in rats and initial glucose level taken before the extract was administered and metformin also to the test animals. Blood glucose was obtained from the tail vein of the test animals in 0 hour, 1 hour, 2 hours, 3 hours, 6 hours, 12 hours, 24 hours, 3 days, and 7 days post administration, respectively. The blood glucose level was determined using a fine test glucometer. However, phytochemical screening and Chromatographic separation of the extract were carried out. The result revealed that the methanol extract of Curcuma domestica contained alkaloid, tannin, coumarin, flavonoid, terpenes, phenol, reducing sugar, and LD50 was 500 mg/kg. The result also revealed that at a dose level of 150 mg/kg the extract significantly (p < 0 05) reduced the mean fasting glucose level from 241 ± 0.33 mg/dl (day 0) to 56 ± 0.31 mg/dl (day 7). The column chromatography gave 80 eluates. Eluates 49 -67 gave the same Rf value of 0.50 and was light brown in colour under UV light (254 nm). The antidiabetic property of Curcuma domestica is believed to be due to the presence of bioactive bioactive constituents of the plant observed during phytochemical screening may be responsible for the anti-diabetic activity of the Curcuma domestica extract.

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Management of type 1 and type 2 diabetes requiring insulin

Cited by 6 publications

References 14 publications

Factors associated with withdrawal from insulin pump therapy: A large‐population‐based study

Factors associated with withdrawal from insulin pump therapy: A large‐population‐based study

Integrating Illness Management Into Identity Verification Processes

Rhizome extract of Curcuma domestica L. (Zingiberacae) in Alloxan- induced diabetic rats

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