scholarly journals Insulin Requirements in Relation to Insulin Pump Indications in Type 1 Diabetes

2015 ◽  
Vol 7 (3) ◽  
pp. 259-263
Author(s):  
Gabriela GHIMPEŢEANU ◽  
Silvia Ş. IANCU ◽  
Gabriela ROMAN ◽  
Anca M. ALIONESCU
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Diabetic Patients ◽  
Pump Therapy ◽  
Daily Insulin ◽  
Insulin Requirements ◽  
High Hba1c ◽  
Basal Bolus

The purpose of the current research was to assess changes in daily insulin requirements in type 1 diabetic patients transitioning from multiple daily injections (MDI) of insulin to continuous subcutaneous insulin infusion (CSII) using an external insulin pump, according to clinical indications for changing therapy. The charts of 70 patients with type 1 diabetes (T1D) initiating insulin pump therapy were retrospectively reviewed before CSII and after optimization of glycaemic profile with CSII during hospital admission. Daily insulin doses, basal/bolus distributions, dose changes during treatment transition and glycaemic outcomes with MDI and optimized CSII according to insulin pump indications were evaluated. Daily insulin doses were not significantly different among indication groups, with both MDI and CSII; likewise, the overall daily distribution of basal/rapid insulin ratio was similar, around 40/60. With optimized CSII, significant differences were found only in basal/bolus distribution in patients initiating CSII for recurrent hypoglycemia, who had a significantly lower basal (6.4% lower) and a complementary higher bolus requirement, compared to patients initiating CSII for HbA1c ≥ 8.5%. At transition, basal insulin needs declined similarly in the high HbA1c and impractical/inflexible MDI groups by approximately 20%, and up to 30% in the recurrent hypoglycaemia group; bolus doses decreased by 20% when the indication was high HbA1c and by approximately 15% for the other indications. Glycaemic control was significantly improved only in patients initiating CSII for high HbA1c (≥8.5%). Insulin pump indication should be considered when starting T1D patients on CSII. These findings may support clinicians in decision making regarding insulin dose changes when initiating insulin pump therapy.

scholarly journals Assessment of the “Second Day” Exercise Effect on Glycemic Control, Insulin Requirements, and CHO Intake in Type 1 Diabetes Adults

2019 ◽  
Vol 15 (1) ◽  
pp. 127-133 ◽  
Author(s):  
Michael Müller-Korbsch ◽  
Lisa Frühwald ◽  
Michael Heer ◽  
Maria Fangmeyer-Binder ◽  
David Reinhart-Mikocki ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Aerobic Exercise ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Target Range ◽  
Pump Therapy ◽  
Glucose Levels ◽  
Insulin Requirements ◽  
Mean Glucose

Background: Glucose control during consecutive days of aerobic exercise has not been well studied. We assessed glycemia, insulin requirements, and carbohydrate (CHO) needs during two consecutive days of prolonged cycling in type 1 diabetes (T1D) adults using sensor-augmented insulin pump therapy. Methods: Twenty adults with well-controlled T1D and six healthy adults (for comparison) were enrolled. Assessments were made during two consecutive days of cycling activities (30 miles per day). On day 1 (D1), basal rates were reduced 50% and CHO intake was guided by real-time continuous glucose monitoring (rtCGM) data to maintain a target range (70-180 mg/dL). On day 2 (D2), basal insulin infusion was stopped for the first hour of biking and resumed at a minimal rate during biking. Carbohydrate intake one hour before, during, and ten minutes after biking was recorded. Times within/below target range, glycemic variability, and mean glucose were calculated from rtCGM data. Results: Among 17 T1D participants who completed the study, mean glucose levels at the start of cycling were slightly lower on D2 vs D1: 138 ± 16 mg/dL and 122 ± 16, respectively, P = NS. Type 1 diabetes participants achieved near-normal glucose levels at the end of both cycling events; however, the reduction in glucose was most notable at one hour into the event on D2 vs D1. Carbohydrate intake was notably lower during D2 vs D1 with no difference in time <54 mg/dL (both P = NS). Conclusions: Type 1 diabetes individuals using rtCGM-augmented insulin pump therapy can safely engage in consecutive days of prolonged aerobic exercise by significantly reducing insulin dosages with no increase in CHO intake.

Pregnancy planning in Type 1 diabetes

2016 ◽  
Author(s):  
Nicoletta Dozio
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Population Level ◽  
Insulin Pump Therapy ◽  
Fetal Malformation ◽  
Pump Therapy ◽  
Insulin Requirements ◽  
Background Population

Pregnancy outcomes in Type 1 diabetes have progressively improved, but are not yet at background population level. Insulin requirements increase early in pregnancy, followed by a nadir at 16–18 weeks, consistently climbing nearly to delivery. Everyone who sees Type 1 patients of childbearing years should be able to deliver concise and practical advice on pre-pregnancy management, including contraception advice. About one-third of UK pregnancies are unplanned. Even where formal counselling is readily available, most women do not access it. Maternal risks during pregnancy include exacerbation of pre-existing complications, hypoglycaemia, and pre-eclampsia; foetal risks include pregnancy loss, fetal malformation, prematurity, macrosomia, stillbirth, and neonatal death. Ideal preconception A1C is 6 to 7% (42 to 53 mmol/mol). Most insulin preparations are safe during pregnancy. Continuous glucose monitoring and insulin pump therapy are increasingly used, but evidence of definite benefit is awaited. Women are usually highly motivated to optimize glycaemic control during pregnancy.

Insulin Pump Therapy in Moslem Patients with Type 1 Diabetes During Ramadan Fasting: An Observational Report

2010 ◽  
Vol 12 (4) ◽  
pp. 287-290 ◽  
Author(s):  
Mahmoud M. Benbarka ◽  
Ali B. Khalil ◽  
Salem A. Beshyah ◽  
Suhad Marjei ◽  
Samar Abu Awad
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Ramadan Fasting ◽  
Observational Report

Efficacy of Insulin Pump Therapy in Type 1 Diabetes Mellitus with a Focus on HbA1c Levels in Relation to Patient Age

2019 ◽  
Vol 2 (1) ◽  
pp. 20-21
Author(s):  
Jan Broz ◽  
Denisa Janickova Zdarska ◽  
Michal Policar ◽  
Viera Donicova ◽  
Marek Brabec ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy ◽  
Patient Age ◽  
Patient Âgé ◽  
Hba1c Levels
Sign in / Sign up

Export Citation Format

Share Document