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Insulin infusion therapy. Potential benefits and risks.

R A Bonner

    Postgraduate Medicine
    |May 1, 1985
    PubMed
    Summary

    Euglycemic management using insulin infusion therapy offers flexibility for motivated patients with insulin-dependent diabetes. While not reversing complications, it provides convenient, near-normal glucose control for selected individuals.

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    Area of Science:

    • Endocrinology
    • Metabolic Diseases
    • Diabetes Management

    Background:

    • Insulin-dependent diabetes mellitus (IDDM) management aims for euglycemia.
    • Insulin infusion therapy (IIT) presents potential benefits and risks.
    • Patient selection is crucial for successful IIT.

    Purpose of the Study:

    • To evaluate the role and appropriateness of insulin infusion therapy for euglycemic management in IDDM.
    • To discuss the conveniences and limitations of IIT for selected patients.

    Main Methods:

    • Review of existing evidence on euglycemic management and IIT.
    • Analysis of patient suitability for IIT, considering complications like nephropathy and autonomic neuropathy.
    • Discussion of technological advancements impacting diabetes care.

    Main Results:

    • IIT offers greater mealtime flexibility and premeal bolus infusion convenience compared to injections.
    • Patients with advanced nephropathy or autonomic neuropathy are poor candidates for IIT.
    • IIT does not reverse established diabetes complications.

    Conclusions:

    • Insulin infusion therapy is a viable option for near-euglycemic management in carefully selected, well-motivated patients with IDDM.
    • Future advancements in continuous glucose monitoring, closed-loop systems, and islet transplantation may offer improved euglycemic therapies.
    • IIT, transitioning from a research tool to widespread availability, requires careful patient selection.

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