scholarly journals Effect of Insulin Pump Use on Diabetic Ketoacidosis in Type 1 Diabetes Mellitus: A Matched Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 898
Author(s):  
Abbas Alshami ◽  
Tiffany Purewal ◽  
Steven Douedi ◽  
Mohammed Alazzawi ◽  
Mohammad A. Hossain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Type 1 Diabetes ◽  
Cohort Study ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Insulin Pump ◽  
The United States ◽  
Study Results

Background: Diabetic ketoacidosis (DKA) is a well-known complication of diabetes mellitus with a significantly high mortality if not immediately and properly treated. Therefore, strategies for prevention of DKA are ever so important when managing diabetes mellitus, especially in the non-compliant patient population. Previously studies have suggested insulin pump use to carry an increased risk of DKA compared to insulin injections, while European studies suggest the opposite. We aimed to perform a retrospective cohort study to determine the risk of DKA in insulin pump versus injection in the United States. Methods: We utilized the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) 2017 database, which represents a 20% sample of all payer hospitalizations in the United States. These hospitalizations were systematically selected by the Agency for Healthcare Resources and Quality (AHRQ) and we included all type 1 diabetes mellitus patients over the age of 18 who were on insulin, either pump or injections, in our study. Results: We found a total of 58,260 admissions for patients with type 1 DM. Of these, 7850 had insulin pump, 30,672 used insulin injection, and 19,738 had no prior insulin use. We found that insulin pump use, compared to injections, failed to predict a lower incidence of DKA in hospitalized patients. Conclusion: Although several studies from European countries have found a reduction of DKA risk with insulin pump use, in this study we found no clear significant difference in a United States-based study. While this may be possible due to different legislating and regulation organizations, further studies are warranted to further evaluate the benefit of either insulin dispensing modality.

scholarly journals Assessment of quality of life as an element of monitoring health status in children and adolescents with type 1 diabetes mellitus

2009 ◽  
Vol 12 (3) ◽  
pp. 57-59 ◽  
Author(s):  
Nina Viktorovna Bolotova ◽  
Olga Viktorovna Kompaniets ◽  
Natalya Yur'evna Filina ◽  
Natalya Valer'evna Nikolaeva
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Insulin Pump ◽  
Life Questionnaire ◽  
Study Results

Aim. To assess quality of life (QL) in children and adolescents with type 1 diabetes mellitus (DM1) depending on its duration, mode of insulin administration,and degree of social adaptation. Materials and methods. Generic Core Scale and Diabetes Module of Pediatric Quality of Life Questionnaire were used to estimate QL in 72 diabeticchildren and adolescents aged 5-18 yr with the participation of one of the parents. Patients with severe concomitant pathology were not includedin the study. Results. Overall QL score in children and adolescents with DM1 was 73,043?1,24. The psycho-social activity of most patients in all age groups was ratherhigh in contrast to suppressed physical functions due to complications of DM1 ten or more years in duration (51,4?9,19 scores). The psycho-emotionalstate was less dependent on negative effects of the disease. Patients using an insulin pump had on the whole better QL than those receiving intensiveinsulin therapy (82 and 72 points respectively, p

Type 1 Diabetes Mellitus

2018 ◽  
Author(s):  
Joseph I. Wolfsdorf ◽  
Katharine Garvey
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Pancreatic Beta Cells ◽  
Insulin Pump ◽  
Autoimmune Diabetes ◽  
Clinical Manifestations ◽  
Laboratory Findings

Type 1 diabetes mellitus is a heterogeneous metabolic disease characterized by destruction of the pancreatic beta cells resulting in an absolute deficiency of insulin secretion with subsequent hyperglycemia. This review details the definition and classification, epidemiology, pathophysiology, pathogenesis, prevention, diagnosis, and management of type 1 diabetes mellitus. Figures show the opposing actions of insulin and glucagon, particularly within the liver, on substrate flow and plasma levels; plasma glucose, insulin and C-peptide levels; the structure of human proinsulin; the cellular actions of insulin; measurement of insulin levels after the administration of glucose; the pathways that lead from insulin deficiency to the major clinical manifestations of type 1 diabetes mellitus; the pathogenesis of type 1 autoimmune diabetes mellitus; the relationship between hemoglobin A1C and calculated average glucose level; basal-bolus and insulin pump regimens; and management of diabetic ketoacidosis. Tables list the etiologic classification of diabetes mellitus, criteria for the diagnosis of diabetes, American Diabetes Association standards for glycemic control in diabetes mellitus, insulin preparations, potential advantages of continuous subcutaneous insulin infusion compared with multiple daily injections, cardiovascular risk factor screening and treatment, and typical admission laboratory findings and monitoring in diabetic ketoacidosis. This review contains 10 highly rendered figures, 7 tables, and 66 references.

Factors influencing adherence among youth with Type-1-Diabetes Mellitus - the Hungarian case

2020 ◽  
Vol 16 ◽  
Author(s):  
Beáta Erika Nagy ◽  
Brigitta Munkácsi ◽  
Karolina Eszter Kovács
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Birth Order ◽  
Insulin Pump ◽  
Demographic Variables ◽  
Insulin Pump Therapy ◽  
Factors Influencing ◽  
Group Comparisons

Background & Introduction: Due to the increasing prevalence of type-1-diabetes an increasing number of studies draws investigation draws attention to its psychological effects and long-term consequences. As Type 1 Diabetes Mellitus is a chronic, non-curable, yet maintanable condition, with the affected children and their families facing a lifelong challenge. Our research focuses on the factors influencing adherence. Methods & Results: The adherence of youth was examined in a sample involving 114 patients treated in the Medical and Health Science Centre at the University of Debrecen by employing a new adherence questionnaire (DAQ abbreviated version, Munkácsi et al, 2019) (DAF 2017; N=114). The influence of socio-demographic variables and those related to the disease (age at the diagnosis, time elapsed since diagnosis, method of treatment, the time elapsed since the use of the pump) were measured by linear regression. Furthermore, the between-group comparisons were made by independent sample t-tests and variance analysis. The investigation was carried out between September 2017 and May 2018. The effect of using insulin pump as therapy is significant and positive (0.36. p=0.045). The adherence of the patients using insulin pump is higher while the effect of the age at the diagnosis has a significantly negative effect (-.247, p=0.035). Thus, earlier detection of the disease may lead to a higher level of adherence. The effects of the socio-demographic variables (gender, family structure, educational level, type of the settlement, owning sibling and birth order) were not significant (p>0.05). Regarding the between-group comparisons, a significant difference could be pointed out concerning the siblings and birth-order as the adherence of the those with siblings was higher (p=0.044). Moreover, concerning insulin pump therapy, the adherence of patients using pump was significantly better (p=0.048). Also, regarding the age of the diagnosis, the adherence of those diagnosed before 12 was seemingly higher (p=0.039). Concerning the other socio-demographical and disease-related variables, no significant differences could be detected. Conclusions: The results suggest that the treatment has an outstanding role in the adherence of the disease. Moreover, the role of the appropriate treatment, living conditions as well as the early diagnosis is relevant.

MCP-1and IL-1β expression in the myocardia of two young patients with Type 1 diabetes mellitus and fatal diabetic ketoacidosis

2014 ◽  
Vol 96 (1) ◽  
pp. 71-79 ◽  
Author(s):  
Jianli Niu ◽  
M.G.F. Gilliland ◽  
Zhuqing Jin ◽  
Pappachan E. Kolattukudy ◽  
William H. Hoffman
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Young Patients
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