scholarly journals Placement of insulin pump by telemedicine

2020 ◽  
Vol 23 (4) ◽  
pp. 281
Author(s):  
Foglia , A.
Keyword(s):  
Insulin Therapy ◽  
Insulin Pump ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Insulin Pumps ◽  
Pump System ◽  
Telemedicine System ◽  
Glycemic Monitoring

In the lockdown period, during the recent pandemic from COVID-19, the use of telemedicine for all categories of chronic patients has been encouraged by all scientific societies and governing bodies. In type 1 diabetic patients, telemedicine has been used for some time to control and verify the state of metabolic balance, through specific platforms for data download. There are numerous evidences that support the positive effect of insulin therapy by insulin pump (CSII) compared to multinjective insulin therapy and the use of continuous blood glucose monitoring systems (CGM) and integrated insulin pump systems and glycemic monitoring (SAP). The purpose of our study is to describe the results of our first experience of remote implants through the use of telemedicine of insulin pumps and continuous glycemic monitoring in four patients with type 1 diabetes in low metabolic compensation complicated by hypoglycemias. Two weeks after the insulin pump has been implanted, a hypoglycemic episode reset was recorded in all patients and the ‘time in range’ was greater than 90% in three of the four patients. Furthermore, the implanted patients were given a survey to evaluate their experience and everyone declared that they were satisfied overall. Our first and small experience of pump system through the use of remote technologies has obtained encouraging results and could be taken into consideration for the therapeutic management of selected patients, trained in the use of technologies and followed over time. KEY WORDS diabetes mellitus; insulin pumps; telemedicine system.

The Predictive Low Glucose Management System in Prevention of Clinically Significant Hypoglycemia in Type 1 Diabetes. A Preliminary Study Identifying the Most Common Events Leading Up to Hypoglycemia During Insulin Pump Therapy

2019 ◽  
Author(s):  
Petros Thomakos ◽  
Asimina Mitrakou ◽  
Olga Kepaptsoglou ◽  
Ibrahim Taraoune ◽  
Carol Barreto ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Insulin Pumps ◽  
Pump System ◽  
High Blood Glucose ◽  
Low Glucose ◽  
Clinically Significant ◽  
Glucose Management

Abstract Background/aim Prevention of hypoglycemia remains a major challenge in diabetic management, despite the introduction of modern insulin pumps in daily clinical practice. The Low Glucose Suspend (LGS) and the newer Predictive Low Glucose Management (PLGM) systems incorporated in the Medtronic insulin pumps have shown promising results in prevention of hypoglycemia. Our aim was to evaluate the effect of the 2 systems relative to the frequency of clinically significant hypoglycemia in Type 1 diabetes (T1DM). In addition, we investigated the events preceding clinically significant hypoglycemia episodes. Methods A cross-sectional study was conducted in 30 T1DM patients using the MiniMed 640G vs. 30 using the MiniMed Veo sensor-augmented insulin pump. All data was recorded during patients’ normal daily activity and living conditions. The patients were matched for age and duration of diabetes. Results PLGM use was associated with lower incidence of clinically significant hypoglycemia (1.9±1.4 vs. 3.6±1.9 episodes per week), along with reduced exposure to hypoglycemia. The data indicated that both pump systems are effective in preventing severe hypoglycemic episodes. In both groups the most common events preceding hypoglycemic episodes included adjustment of hyperglycemia, basal rate increase and miscalculation of carbohydrates. Conclusions The results indicated that the use of the Minimed 640G pump system can help reduce the frequency of clinically significant hypoglycemia. Management of hyperglycemia must be addressed in diabetes education programs in order to encourage proper adjustment of high blood glucose levels. Future studies would be useful in exploring the details of the events preceding hypoglycemia episodes in insulin pump users.

scholarly journals Diabetes management in telemedicine: patients’ opinion (preliminary data)

2021 ◽  
Vol 24 (2) ◽  
pp. 97
Author(s):  
Foglia, A.
Keyword(s):  
Diabetes Mellitus ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Telemedicine System ◽  
Campania Region

With the outbreak of the COVID-19 pandemic and the resulting restrictions, telemedicine has enabled healthcare to be provided to patients with chronic diseases, although with some restrictions. During the lockdown The Campania region was the first to order (03/27/2020), to protect the health of citizens suffering from diabetes mellitus, the use of telemedicine and a tele-health service was activated in our clinics. At the end of the consultation, a survey was submitted to our diabetic patients in order to evaluate their opinion about the telemedicine experience in comparison with the traditional clinic visit. 100% of both type 1 and type 2 patients consider the telemedicine visit adequate, 89.2% of types 1 and 75.9% of types 2 consider the two forms of visit absolutely overlapping from a professional point of view, and even 6.9% of type 2, but none of type 1, considers the tele-visit more effective than the traditional visit. However, only 44.8% (type 2 diabetic patients) and 13,5%% (type 1 diabetic patients) expressed a preference for telemedicine visits over traditional visits. Telemedicine has allowed continuity of care for diabetic patients despite the difficulties of this emergency time. We believe that the opinion of patients and health care professionals on the telemedicine experience can be useful to assess the limitations and advantages in order to improve and enhance the use of this method. KEY WORDS diabetes mellitus; telemedicine system; survey.

New horizons for insulin therapy with a pump: the artificial pancreas

2021 ◽  
Vol 24 (2) ◽  
pp. 86
Author(s):  
Papa, G.
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Closed Loop ◽  
Insulin Pump ◽  
Artificial Pancreas ◽  
Glucose Sensors ◽  
Daily Injection ◽  
Insulin Pumps

The monitoring and treatment of type 1 diabetes (T1D) are undergoing profound changes today. Notable steps include the improvement and widespread adoption of glucose sensors which are now extremely reliable and furthermore are used with insulin pumps in an integrated manner. Over the last 2 to 3 years these systems have evolved rapidly with the development and use of algorithms which permit the autonomous regulation of basal insulin. Correct control and administration of basal insulin is often the greatest stumbling block in multiple daily injection therapy as basal insulins cannot replicate the physiological rhythms of basal insulin secretion. Hypoglycemia is another critical point in standard insulin pen therapy as it does not permit dosage modulation in the same way as with an insulin pump. In this article we cover the fundamental steps in this revolution of insulin therapy which promises, in the not too distant future, the ultimate achievement of the artificial pancreas and thus the complete closure of the loop. All those working in diabetes care must be adequately trained and familiar with this technology as it should no longer be considered a niche treatment reserved for carefully selected patients and managed in only a few centers of excellence. In order to choose the best treatment, tailored to each individual patient’s needs, medical staff involved in the treatment of T1D require a thorough knowledge of standalone glucose sensors, insulin pumps and integrated systems with control algorithms.Once the critical issues (costs, psychological aspects, system management difficulties, alarm fatigue, etc.) still related to their use have been resolved, new Hybrid Closed Loop and Advanced Hybrid Closed Loop systems could become the new standard in the treatment of T1D. KEY WORDS type 1 Diabetes; insulin pump; decision-making algorithms; integrated system.

scholarly journals Specific use of CSII during enteral nocturnal nutrition in a child with type 1 diabetes, Hashimoto's thyroiditis, and Down syndrome

2013 ◽  
Vol 57 (5) ◽  
pp. 388-392 ◽  
Author(s):  
Barbara Piccini ◽  
Sonia Toni ◽  
Lorenzo Lenzi ◽  
Federica Barni ◽  
Monica Guasti ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Enteral Feeding ◽  
Case Reports ◽  
Scientific Evidence ◽  
Nutrition Therapy ◽  
Artificial Nutrition ◽  
Diabetic Patients ◽  
Glucose Levels

The management of insulin therapy in diabetic patients who have comorbidities that involve nutritional aspects, is a major challenge for diabetes care teams. In diabetic patients with compromised nutritional status, artificial nutrition, both enteral or parenteral, may help in the treatment of chronic and acute diseases, leading to better and faster recover of the health status but, if not adequately associated with insulin therapy, it may negatively affect blood glucose levels and lead to poorer metabolic control. In particular, evidence-based recommendations for the treatment of diabetic patients during enteral nutrition therapy are not currently available and, therefore, medical practices are often based on case reports, rather than outcomes of research. We report our experience with a diabetic patient receiving nocturnal enteral feeding due to comorbidities and malnutrition, who was followed up at our centre and precociously treated with continuous subcutaneous insulin infusion after the onset of type 1 diabetes. There is great need for adequately powered randomized controlled trials to provide scientific evidence for the insulin treatment of diabetic patients undergoing enteral feeding.

Factors related to insulin resistance in type 1 diabetic patients treated with intensive insulin therapy from the onset of the disease

2010 ◽  
Vol 90 (2) ◽  
pp. e23-e24 ◽  
Author(s):  
Aleksandra Araszkiewicz ◽  
Aleksandra Uruska ◽  
Dorota Zozulinska-Ziolkiewicz ◽  
Stanislaw Pilacinski ◽  
Bogna Wierusz-Wysocka
Keyword(s):  
Insulin Resistance ◽  
Insulin Therapy ◽  
Intensive Insulin Therapy ◽  
Diabetic Patients ◽  
Type 1 Diabetic Patients
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