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Continuous subcutaneous insulin infusion: an approach to achieving normoglycaemia.
Open accessAbstract
A study was performed to examine the feasibility of achieving long periods of near-normoglycaemia in patients with diabetes mellitus by giving a continuous subcutaneous infusion of insulin solution from a miniature, battery-driven, syringe pump. Twelve insulin-dependent diabetics had their insulin pumped through a subcutaneously implanted, fine nylon cannula; the basal infusion rate was electronically stepped up eightfold before meals. The blood glucose profile of these patients was closely monitored during the 24 hours of the subcutaneous infusion and compared with the profile on a control day, when the patients were managed with their usual subcutaneous insulin. Diet and exercise were standardised on both days. In five out of 14 studies the subcutaneous insulin infusion significantly lowered the mean blood glucose concentration without producing hypoglycaemic symptoms; in another six patients the mean blood glucose concentration was maintained. As assessed by the M value the level of control was statistically improved in six out of 14 studies by the infusion method and maintained in six other patients. To assess the effects of blood glucose control on diabetic microvascular disease it will be necessary to achieve long-term normoglycaemia in selected diabetics. The results of this preliminary study suggest that a continuous subcutaneous insulin infusion may be a means of maining physiological glucose concentrations in diabetics. Though several problems remain--for example, in determining the rate of infusion--longer-term studies with the miniature infusion pumps are now needed.
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“Continuous subcutaneous insulin infusion (CSII) with a portable pump is an insulin therapy system first built in 1976 by Pickup and Keen for research purposes.[1,6] At that time, the size of the pump was equal to that of a back bag.”
BackgroundMethodGibney, M., Xue, Z., Swinney, M., Bialonczyk, D., & Hirsch, L. (2016) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2015.0342 · Cited by 32
SERVICE, F. J., RIZZA, R. A., HALL, L. D., WESTLAND, R. E., O’BRIEN, P. C., CLEMENS, A. H., HAYMOND, M. W., & GERICH, J. E. (1983) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-57-5-931 · Cited by 25
Kampmann, U., Madsen, L. R., Bjerg, L., Witte, D. R., Hasselstrøm, K., Østergård, T., Alstrup, K., Møller, M. K., Dylmer, D., & Hansen, K. W. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.04.042 · Cited by 19
Metadata
- Authors
- Pickup, J. C., Keen, H., Parsons, J. A., & Alberti, K. G.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1978-01-28
- Volume
- 1
- Issue
- 6107
- Pages
- 204-207
- ISSN
- 0007-1447 (ISSN-L)
- 1468-5833
- OpenAlex
- W2077270061
- Cited by
- 563
- References
- 0
- FWCI
- 30.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
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