Continuous subcutaneous insulin infusion (CSII insulin pump therapy) for type 1 diabetes: A Bournemouth perspective

This source preferred by David Kerr and Janet James

Authors: Kerr, D., Nicholls, H. and James, J.

http://dx.doi.org/10.1002/pdi.1224

Journal: Practical Diabetes International

Volume: 25

Pages: 114-117

ISSN: 1357-8170

DOI: 10.1002/pdi.1224

The first patient in Bournemouth to use insulin pump therapy started in 1998. Subsequently, meta-analyses have supported our clinical experience that, for carefully selected individuals with type 1 diabetes, insulin pump therapy is associated with: reductions in HbA1c of 0.5-0.9% compared to multiple injection therapy; fewer glycaemic excursions above and below target levels compared to traditional injection therapy with patients reporting marked improvements in well-being; reduction in the risk of severe hypoglycaemic episodes, particularly at night; and improved quality of life. Starting insulin pump therapy requires a specialist multidisciplinary team for selection of patients for continuous subcutaneous insulin infusion, and to provide the on-going education. Before starting pump therapy, patients should have participated in a structured group education programme whilst on multiple daily injections of insulin. Once established, the use of additional technologies including continuous glucose monitoring and the pump download facilities give significant added value to the clinical care of people with type 1 diabetes opting for this form of insulin delivery. It is important that all patients with type 1 diabetes are made aware of these technologies in diabetes care and, if appropriate, have access to them.

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Authors: Kerr, D., Nicholls, H. and James, J.

Journal: Practical Diabetes International

Volume: 25

Issue: 3

Pages: 114-117

eISSN: 1528-252X

ISSN: 1357-8170

DOI: 10.1002/pdi.1224

The first patient in Boumemouth to use insulin pump therapy started in 1998. Subsequently, meta-analyses have supported our clinical experience that, for carefully selected individuals with type 1 diabetes, insulin pump therapy is associated with: reductions in HbA1c of 0.5-0.9% compared to multiple injection therapy; fewer glycaemic excursions above and below target levels compared to traditional injection therapy with patients reporting marked improvements in well-being; reduction in the risk of severe hypoglycaemic episodes, particularly at night; and improved quality of life. Starting insulin pump therapy requires a specialist multidisciplinary team for selection of patients for continuous subcutaneous insulin infusion, and to provide the on-going education. Before starting pump therapy, patients should have participated in a structured group education programme whilst on multiple daily injections of insulin. Once established, the use of additional technologies including continuous glucose monitoring and the pump download facilities give significant added value to the clinical care of people with type 1 diabetes opting for this form of insulin delivery. It is important that all patients with type 1 diabetes are made aware of the technologies in diabetes care and, if appropriate, have access to them. Copyright © 2008 John Wiley & Sons.

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