Document Detail


[Insulin pump therapy: indications and risks - Case 7/2010].
MedLine Citation:
PMID:  20730708     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HISTORY, ADMISSION FINDINGS AND TREATMENT: In a 35-year-old pregnant woman (pat. 1) with type 1 diabetes, insulin pump therapy was initiated because of very fluctuating blood glucose levels with severe hypoglycaemias and worsening hypoglycaemia unawareness during pregnancy. In a 45-year-old female (pat. 2) with type 1 diabetes, severe hypoglycemia with loss of consciousness occurred because of dysfunction of the insulin pump and subsequent several-fold application of bolus insulin. After intravenous administration of 40% glucose solution the patient recovered soon and was admitted to hospital for further treatment. COURSE: With CSII blood glucose levels were in patient 1 more stable and HbA (1c) remained within the normal range. The pregnancy proceeded without further complications and the patient gave birth to a healthy boy on time. In patient 2, insulin pump treatment was reinititated after a temporarily change to an intensified conventional insulin regimen and an insulin pump therapy education update. CONCLUSION: The main advantage of an insulin pump therapy is the higher flexibility regarding the basal insulin rate, in particular in patients with highly fluctuating insulin demand during the day and/or hypoglycaemia unawareness. As a disadvantage can be seen the higher costs, especially as superiority of insulin pump therapy compared to intensified conventional treatment could not be shown for all patients.
Authors:
Caroline Ketterer; Karsten Müssig; Anna-Katharina Gerstenecker; Andreas Fritsche
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Publication Detail:
Type:  Case Reports; English Abstract; Journal Article     Date:  2010-08-20
Journal Detail:
Title:  Deutsche medizinische Wochenschrift (1946)     Volume:  135     ISSN:  1439-4413     ISO Abbreviation:  Dtsch. Med. Wochenschr.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-15     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  0006723     Medline TA:  Dtsch Med Wochenschr     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  1617     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart * New York.
Affiliation:
Medizinische Universitätsklinik Tübingen, Abteilung für Endokrinologie, Diabetologie, Nephrologie, Angiologie und Klinische Chemie, Tübingen. caroline.ketterer@med.uni-tuebingen.de
Vernacular Title:
Insulinpumpentherapie: Indikationen und Risiken - Fall 7/2010.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism
Diabetes Mellitus, Type 1 / blood,  drug therapy*
Diabetic Coma / blood,  chemically induced
Equipment Failure*
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Hypoglycemia / blood,  chemically induced
Infant, Newborn
Insulin Infusion Systems / adverse effects*
Male
Middle Aged
Pregnancy
Pregnancy in Diabetics / blood,  drug therapy*
Risk Factors
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/hemoglobin A1c protein, human

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