Feasibility and efficacy of long-term treatment by continuous subcutaneous insulin infusion (CSII) in insulin-dependent diabetes
Van Ballegooie, E.; Reitsma, W.D.; Sluiter, W.J.; Doorenbos, H.
Netherlands Journal of Medicine 27(5): 185-192
1984
ISSN/ISBN: 0300-2977 PMID: 6427640 Document Number: 231755
The feasibility and efficacy of long-term continuous s.c. insulin infusion (CSII) was studied in 26 insulin-dependent diabetic patients. The average follow-up period was 17.3 mo. After 6 mo. of pump therapy, mean blood glucose levels (.+-. SD) had decreased from 12.6 .+-. 3.2 mmol/l to 6.4 .+-. 1.8 mmol/l (P < 0.01); mean group glycosylated Hb fell from 12.8 .+-. 1.8% to 8.2 .+-. 1.4% (P < 0.01). Near normoglycemia was achieved in 18 patients, although 8 of them showed temporary deterioration during the study. In 4 patients, the best possible control was only reasonable, and 4 patients remained insufficiently controlled while on CSII. Technical failures and patient errors occurred twice per patient-mo. During 450 patient-months 4 episodes of ketoacidosis and 5 episodes of severe hypoglycemia were seen. Pump therapy was discontinued in 4 patients. CSII in combination with home blood glucose monitoring is a feasible method to improve blood glucose control in carefully instructed diabetic patients. Long-term near normoglycemia is not always achievable.