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2012 | 19 | 3 |

Tytuł artykułu

Efficacy and safety of insulin pump treatment in adult T1DM patients – influence of age and social environment

Treść / Zawartość

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Introduction and objective. Continuous subcutaneous insulin infusion (CSII) via personal insulin pump is a valuable therapeutic tool in T1DM patients. However, adherence to recommended CSII- related behaviours may be of concern to young adults with intensive, variable daily activities (students, young professionals). The aim of this observational study was to estimate treatment outcomes in young adult patients with T1DM, and compare them with older individuals. Materials and methods. Overall, 140 adults with T1DM on CSII were examined, divided into 2 subgroups: 77 patients younger than 26 years of age (mean 20.6 years) and 63 older subjects (mean 39.0). We compared the glycaemic control in both groups of T1DM subjects and analyzed treatment attitudes to identify potentially modifiable behaviours influencing the efficacy of the treatment. Results. The younger individuals were characterized by significantly worse treatment outcomes, compared to the older ones: the mean HbA1c levels were 7.6 ± 1.3% and 6.9±1.3% (p=0.00001), while the mean glucose levels based on glucometer downloads were 161±33.6 mg/dL and 136±21.8 mg/dL (p=0.00001), respectively. The frequency of self-monitoring of blood glucose (SMBG) was lower in younger individuals (5.3±2.1 vs. 7.0±2.8 daily, p=0.0005, respectively); they were also less frequently used advanced pump functions, e.g. the bolus calculator (48% vs. 67% users, p=0.0014, respectively). Conclusions. The efficacy of CSII treatment observed in young T1DM adults was worse than in older patients. The reason for this phenomenon remains unclear, it may be due simply to age-dependend behaviours, to social environment, or both.

Słowa kluczowe

Wydawca

-

Rocznik

Tom

19

Numer

3

Opis fizyczny

p.573-575,fig.,ref.

Twórcy

autor
  • Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
autor
  • Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland
autor
  • Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; University Hospital, Krakow, Poland
autor
  • Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; University Hospital, Krakow, Poland
  • Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; University Hospital, Krakow, Poland
autor
  • Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; University Hospital, Krakow, Poland

Bibliografia

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  • 3. Hoogma RP, Hammond PJ, Gomis R, Kerr D, Bruttomesso D, Bouter KP, et al. 5-Nations Study Group. Comparison of the effects of continuoussubcutaneous insulin infusion (CSII) and NPH-based multiple dailyinsulin injections (MDI) on glycaemic control and quality of life: resultsof the 5-nations trial. Diabet Med. 2006; 23(2): 141-7.
  • 4. Bruttomesso D, Costa S, Baritussio A. Continuous subcutaneous insulin infusion (CSII) 30 years later: still the best option for insulin therapy.Diabetes Metab Res Rev. 2009; 25(2): 99-111.
  • 5. Pickup JC, Keen H, Parsons JA, Alberti KGMM. Continuous subcutaneous insulin infusion: an approach to achievingnormoglycemia. Br Med J. 1978; 1(6107): 204-207.
  • 6. Pickup J, Keen H. Continuous subcutaneous insulin infusion at 25 years: evidence base for the expanding use of insulin pump therapy intype 1 diabetes. Diabetes Care. 2002; 25(3): 593-8.
  • 7. Bode BW, Tamborlane WV, Davidson PC. Insulin pump therapy in the 21st century. Strategies for successful use in adults, adolescents, andchildren with diabetes. Postgrad Med. 2002; 111(5): 69-77.
  • 8. Nicolucci A, Maione A, Franciosi M, Amoretti R, Busetto E, Capani F, et al. Quality of life and treatment satisfaction in adults with Type 1 diabetes: a comparison between continuous subcutaneous insulininfusion and multiple daily injections. http://www.ncbi.nlm.nih.gov/pubmed/18201210 (access: 2012. 05. 08).
  • 9. Barnard KD, Lloyd CE, Skinner TC. Systematic literature review: quality of life associated with insulin pump use in Type 1 diabetes.Diabet Med. 2007; 24: 607-617.
  • 10. Matejko B, Cyganek K, Katra B, Galicka-Latala D, Grzanka M, Malecki MT, Klupa T. Insulin pump therapy is equally effective and safe inelderly and young type 1 diabetes patients. Rev Diabet Stud. 2011;8(2): 254-8.
  • 11. Cukierman-Yaffe T, Konvalina N, Cohen O. Key elements for successful intensive insulin pump therapy in individuals with type 1 diabetes. Diabetes Res Clin Pract. 2011;92(1): 69-73.
  • 12. Bode BW, Tamborlane WV, Davidson PC. Insulin pump therapy in the 21st century. Strategies for successful use in adults, adolescents, and children with diabetes. Postgrad Med. 2002; 111(5): 69-77.
  • 13. Hamburg BA. Psychosocial development. In: Friedman SB, et al., editors. Comprehensive Adolescent Health Care. 2. St. Louis; Mosby: 1998. pp. 38-49.
  • 14. Davidson M, Penney ED, Muller B, Grey M. Stressors and self-care challenges faced by adolescents living with type 1 diabetes. Appl Nurs Res. 2004; 17:72-80.
  • 15. Schilling LS, Knafl KA, Grey M. Changing patterns of self-management in youth with type I diabetes. J Pediatr Nurs. 2006; 21: 412-424.
  • 16. Comeaux SJ, Jaser SS. Autonomy and insulin in adolescents with type 1 diabetes. Pediatr Diabetes. 2010; 11(7): 498-504.
  • 17. Pańkowska E, Szypowska A, Lipka M, Szpotańska M, Błazik M, Groble L. Application of novel dual wale meal bolus and its impact on glycated hemoglobin A1c level In children with type 1 diabetes. Pediatr Diabetes. 2009; 10(5): 298-303.
  • 18. Klupa T, Skupien J, Cyganek K, Katra B, Sieradzki J, Malecki MT. The dual-wave bolus feature in type 1 diabetes adult users of insulin pumps.Acta Diabetol. 2011; 48(1): 11-4.
  • 19. Ziegler R, Heidtmann B, Hilgard D, Hofer S, Rosenbauer J, Holl R. Frequency of SMBGcorrelates with HbA1c and acute complications inchildren and adolescents with type 1 diabetes. http://www.ncbi.nlm.nih.gov/pubmed/20337978 (access: 2012. 05. 08).
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