Literature DB >> 19885096

Combined insulin pump therapy with real-time continuous glucose monitoring significantly improves glycemic control compared to multiple daily injection therapy in pump naïve patients with type 1 diabetes; single center pilot study experience.

Scott W Lee1, Tom Sweeney, Debbie Clausen, Celia Kolbach, Allen Hassen, Anthony Firek, Charles Brinegar, Jerrold Petrofsky.   

Abstract

OBJECTIVES: This study assessed the safety and clinical effectiveness of the training protocol for initiating insulin pump therapy with real-time continuous glucose monitoring (MiniMed Paradigm REAL-Time System) in a stepwise approach on pump naive subjects with type 1 diabetes compared to a control group who remained on multiple daily injection (MDI) therapy.
METHODS: This was a 15-week treat-to-target pilot study of 16 adult subjects (n = 50% male, age 45.9 +/- 16 years) with type 1 diabetes (duration of diabetes 21.9 +/- 11 years) on MDI therapy with hemoglobin A1c levels at or above 7.5% at baseline. Subjects were randomized to either the study arm (using a combined insulin pump and real-time continuous glucose monitoring system) or the control arm [which continued on MDI therapy with self-monitored blood glucose (SMBG) only]. All subjects dosed insulin according to results of SMBG by finger stick and uploaded data into the CareLink data management software.
RESULTS: Significant improvements in glycemic control were observed from baseline in both study groups-study arm: pre-A1c 9.45 +/- 0.55 and post-A1c 7.4 +/- 0.66 (p = 0.00037); control arm: pre-A1c 8.58 +/- 1.30 and post-A1c 7.5 +/-1.01 (p = 0.04). Both arms had no incidence of severe hypoglycemia.
CONCLUSION: In this pilot study, the Paradigm REAL-Time System was initiated safely and effectively in type 1 diabetes patients who were pump naïve using a stepwise educational protocol.

Entities:  

Keywords:  augmented; diabetes; paradigm; pump; real time; sensor

Year:  2007        PMID: 19885096      PMCID: PMC2769585          DOI: 10.1177/193229680700100313

Source DB:  PubMed          Journal:  J Diabetes Sci Technol        ISSN: 1932-2968


  17 in total

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3.  Standards of medical care for patients with diabetes mellitus.

Authors: 
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4.  Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type I diabetes.

Authors:  B W Bode; R D Steed; P C Davidson
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5.  Continuous subcutaneous insulin infusion. A new way to lower risk of severe hypoglycemia, improve metabolic control, and enhance coping in adolescents with type 1 diabetes.

Authors:  E A Boland; M Grey; A Oesterle; L Fredrickson; W V Tamborlane
Journal:  Diabetes Care       Date:  1999-11       Impact factor: 19.112

Review 6.  Reemergence of insulin pump therapy in the 1990s.

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Review 8.  Diabetes management in the new millennium using insulin pump therapy.

Authors:  Bruce W Bode; Hassan T Sabbah; Todd M Gross; Linda P Fredrickson; Paul C Davidson
Journal:  Diabetes Metab Res Rev       Date:  2002 Jan-Feb       Impact factor: 4.876

9.  Subcutaneous glucose predicts plasma glucose independent of insulin: implications for continuous monitoring.

Authors:  K Rebrin; G M Steil; W P van Antwerp; J J Mastrototaro
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10.  The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.

Authors:  D M Nathan; S Genuth; J Lachin; P Cleary; O Crofford; M Davis; L Rand; C Siebert
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  5 in total

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3.  Lessons learned from a pilot RCT of simultaneous versus delayed initiation of continuous glucose monitoring in children and adolescents with type 1 diabetes starting insulin pump therapy.

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5.  The JDRF CCTN CGM TIME Trial: Timing of Initiation of continuous glucose Monitoring in Established pediatric type 1 diabetes: study protocol, recruitment and baseline characteristics.

Authors:  Margaret L Lawson; Brenda Bradley; Karen McAssey; Cheril Clarson; Susan E Kirsch; Farid H Mahmud; Jacqueline R Curtis; Christine Richardson; Jennilea Courtney; Tammy Cooper; Cynthia J Downie; Gopalan Rajamannar; Nicholas Barrowman
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  5 in total

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