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Comparison of metabolic and psychological parameters during continuous subcutaneous insulin infusion and intensified conventional insulin treatment in type I diabetic patients. 1985

Y Schottenfeld-Naor, and A Galatzer, and M Karp, and Z Josefsberg, and Z Laron

Two methods of insulin treatment--intensified conventional therapy (ICT) of three to four daily injections and continuous s.c. insulin infusion (CSII)--were compared in nine patients with insulin-dependent diabetes mellitus (mean age +/- SD 29.4 +/- 5.6 years; duration of diabetes 14.6 +/- 2.9 years). Patients followed each regimen for 3 to 4 months. Under both regimens hemoglobin A1 (HbA1) levels were lower than those recorded previously, but under CSII the mean HbA1 and glucose levels were significantly lower than under ICT (7.8 +/- 0.1 vs. 8.9 +/- 0.2% for HbA1 and 136 +/- 40 vs. 155 +/- 60 mg/dl for blood glucose, P less than 0.001). There was no difference in the frequency of blood glucose levels less than 60 mg/dl, but under CSII hypoglycemic symptoms appeared at lower glucose levels. There was no marked difference between the two regimens regarding scores for depression and anxiety and other psychological parameters, but patients who chose to continue treatment with CSII following completion of the study had previously manifested a significantly higher degree of distress symptoms, which had been reduced during the study. CSII was preferred by some patients because of the superior metabolic control achieved and the greater flexibility in time and size of meals permitted, but was rejected by others because of technical failures and bulkiness of the device. It is concluded that metabolic control can be improved by either regimen, but external pumps must be further miniaturized and technical failures eliminated before CSIII is acceptable to larger numbers of patients.

UI MeSH Term Description Entries
D007003 Hypoglycemia A syndrome of abnormally low BLOOD GLUCOSE level. Clinical hypoglycemia has diverse etiologies. Severe hypoglycemia eventually lead to glucose deprivation of the CENTRAL NERVOUS SYSTEM resulting in HUNGER; SWEATING; PARESTHESIA; impaired mental function; SEIZURES; COMA; and even DEATH. Fasting Hypoglycemia,Postabsorptive Hypoglycemia,Postprandial Hypoglycemia,Reactive Hypoglycemia,Hypoglycemia, Fasting,Hypoglycemia, Postabsorptive,Hypoglycemia, Postprandial,Hypoglycemia, Reactive
D007279 Injections, Subcutaneous Forceful administration under the skin of liquid medication, nutrient, or other fluid through a hollow needle piercing the skin. Subcutaneous Injections,Injection, Subcutaneous,Subcutaneous Injection
D007328 Insulin A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1). Iletin,Insulin A Chain,Insulin B Chain,Insulin, Regular,Novolin,Sodium Insulin,Soluble Insulin,Chain, Insulin B,Insulin, Sodium,Insulin, Soluble,Regular Insulin
D007332 Insulin Infusion Systems Portable or implantable devices for infusion of insulin. Includes open-loop systems which may be patient-operated or controlled by a pre-set program and are designed for constant delivery of small quantities of insulin, increased during food ingestion, and closed-loop systems which deliver quantities of insulin automatically based on an electronic glucose sensor. Pancreas, Artificial Endocrine,Programmable Implantable Insulin Pump,beta Cell, Artificial,Implantable Programmable Insulin Pump,Insulin Pump, Programmable Implantable,Pump, Programmable Implantable Insulin,Artificial Endocrine Pancreas,Artificial beta Cell,Artificial beta Cells,Cell, Artificial beta,Cells, Artificial beta,Endocrine Pancreas, Artificial,Infusion System, Insulin,Infusion Systems, Insulin,Insulin Infusion System,System, Insulin Infusion,Systems, Insulin Infusion,beta Cells, Artificial
D008297 Male Males
D010342 Patient Acceptance of Health Care Patients' willingness to receive health care. Acceptability of Health Care,Health Care Seeking Behavior,Acceptability of Healthcare,Acceptors of Health Care,Health Care Utilization,Nonacceptors of Health Care,Patient Acceptance of Healthcare,Care Acceptor, Health,Care Acceptors, Health,Care Nonacceptor, Health,Care Nonacceptors, Health,Health Care Acceptability,Health Care Acceptor,Health Care Acceptors,Health Care Nonacceptor,Health Care Nonacceptors,Healthcare Acceptabilities,Healthcare Acceptability,Healthcare Patient Acceptance,Healthcare Patient Acceptances,Utilization, Health Care
D010349 Patient Compliance Voluntary cooperation of the patient in following a prescribed regimen. Client Adherence,Client Compliance,Non-Adherent Patient,Patient Adherence,Patient Cooperation,Patient Noncompliance,Patient Non-Adherence,Patient Non-Compliance,Patient Nonadherence,Therapeutic Compliance,Treatment Compliance,Adherence, Client,Adherence, Patient,Client Compliances,Compliance, Client,Compliance, Patient,Compliance, Therapeutic,Compliance, Treatment,Cooperation, Patient,Non Adherent Patient,Non-Adherence, Patient,Non-Adherent Patients,Non-Compliance, Patient,Nonadherence, Patient,Noncompliance, Patient,Patient Non Adherence,Patient Non Compliance,Patient, Non-Adherent,Therapeutic Compliances,Treatment Compliances
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive

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