Clinical Use of the Insulin Infusion Pump in 100 Patients with Type I Diabetes
We investigated the efficacy of insulin-pump therapy in insulin-dependent diabetics, aged 18 to 69 years, by comparing the metabolic control achieved in 100 patients using this technique with that previously obtained by conventional insulin therapy. Patients were followed during pump therapy for as...
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| Veröffentlicht in: | The New England journal of medicine 1982-08, Vol.307 (9), p.513-518 |
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| container_title | The New England journal of medicine |
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| creator | Mecklenburg, Robert S Benson, James W Becker, Nancy M Brazel, Patricia L Fredlund, Paul N Metz, Robert J Nielsen, Robert L Sannar, Carolyn A Steenrod, William J |
| description | We investigated the efficacy of insulin-pump therapy in insulin-dependent diabetics, aged 18 to 69 years, by comparing the metabolic control achieved in 100 patients using this technique with that previously obtained by conventional insulin therapy. Patients were followed during pump therapy for as long as 15 months. Fasting and nonfasting blood glucose levels (mean ±S.E.M.) decreased from 201±6 and 213±6 mg per deciliter (11.2±0.3 and 11.8±0.3 mmol per liter), respectively, to 158±5 and 145±3 mg per deciliter (8.77±0.3 and 8.05±0.2 mmol per liter) after one month of pump therapy (P |
| doi_str_mv | 10.1056/NEJM198208263070901 |
| format | Article |
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OPEN-LOOP insulin-infusion pumps and home glucose monitoring have been used to achieve striking improvement in the control of diabetes in small numbers of highly supervised patients.
1
2
3
The feasibility of applying these techniques to large numbers of patients over extended periods for the purpose of investigating the relation between glycemic control and the chronic complications of diabetes has not been established. The practicality of using insulin-infusion pumps in clinical practice has been a matter of debate.
4
We have investigated the feasibility of applying these techniques to large-scale clinical research studies and to clinical practice by comparing the metabolic control attained by . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198208263070901</identifier><identifier>PMID: 7099222</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Adolescent ; Adult ; Aged ; Blood glucose ; Blood Glucose - analysis ; Blood levels ; Clinical medicine ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - blood ; Diabetes Mellitus - classification ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetic ketoacidosis ; Fasting ; Female ; Glucose ; Glycated Hemoglobin A - analysis ; Hemoglobin ; Humans ; Hypoglycemia ; Insulin ; Insulin Infusion Systems ; Ketoacidosis ; Laboratories ; Male ; Metabolism ; Middle Aged ; Patient Acceptance of Health Care ; Patient Education as Topic ; Patients ; Sugar ; Time Factors ; Values</subject><ispartof>The New England journal of medicine, 1982-08, Vol.307 (9), p.513-518</ispartof><rights>Copyright Massachusetts Medical Society Aug 26, 1982</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c401t-4934d702d0277e88eb03a4ecbb28597949ca1250cf989e9167f6668facf512103</citedby><cites>FETCH-LOGICAL-c401t-4934d702d0277e88eb03a4ecbb28597949ca1250cf989e9167f6668facf512103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1872277175?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7099222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mecklenburg, Robert S</creatorcontrib><creatorcontrib>Benson, James W</creatorcontrib><creatorcontrib>Becker, Nancy M</creatorcontrib><creatorcontrib>Brazel, Patricia L</creatorcontrib><creatorcontrib>Fredlund, Paul N</creatorcontrib><creatorcontrib>Metz, Robert J</creatorcontrib><creatorcontrib>Nielsen, Robert L</creatorcontrib><creatorcontrib>Sannar, Carolyn A</creatorcontrib><creatorcontrib>Steenrod, William J</creatorcontrib><title>Clinical Use of the Insulin Infusion Pump in 100 Patients with Type I Diabetes</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>We investigated the efficacy of insulin-pump therapy in insulin-dependent diabetics, aged 18 to 69 years, by comparing the metabolic control achieved in 100 patients using this technique with that previously obtained by conventional insulin therapy. Patients were followed during pump therapy for as long as 15 months. Fasting and nonfasting blood glucose levels (mean ±S.E.M.) decreased from 201±6 and 213±6 mg per deciliter (11.2±0.3 and 11.8±0.3 mmol per liter), respectively, to 158±5 and 145±3 mg per deciliter (8.77±0.3 and 8.05±0.2 mmol per liter) after one month of pump therapy (P<0.001). Ninety-three patients had improved blood sugar control; 71 per cent had a mean blood sugar concentration of 150 mg per deciliter (8.3 mmol per liter) or less after six months. Glycosylated hemoglobin values became normal in 44 per cent of 88 patients who had follow-up determinations. In over 500 patient-months there were four episodes of ketoacidosis and five episodes of serious hypoglycemia. Three patients abandoned pump therapy. We conclude that insulin-pump therapy is acceptable to patients and that it can be successfully applied to clinical practice and large-scale research studies. (N Engl J Med. 1982; 307:513–8.)
OPEN-LOOP insulin-infusion pumps and home glucose monitoring have been used to achieve striking improvement in the control of diabetes in small numbers of highly supervised patients.
1
2
3
The feasibility of applying these techniques to large numbers of patients over extended periods for the purpose of investigating the relation between glycemic control and the chronic complications of diabetes has not been established. The practicality of using insulin-infusion pumps in clinical practice has been a matter of debate.
4
We have investigated the feasibility of applying these techniques to large-scale clinical research studies and to clinical practice by comparing the metabolic control attained by . . .</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Blood glucose</subject><subject>Blood Glucose - analysis</subject><subject>Blood levels</subject><subject>Clinical medicine</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus - blood</subject><subject>Diabetes Mellitus - classification</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetic ketoacidosis</subject><subject>Fasting</subject><subject>Female</subject><subject>Glucose</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Hemoglobin</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Insulin</subject><subject>Insulin Infusion Systems</subject><subject>Ketoacidosis</subject><subject>Laboratories</subject><subject>Male</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Patient Acceptance of Health Care</subject><subject>Patient Education as Topic</subject><subject>Patients</subject><subject>Sugar</subject><subject>Time Factors</subject><subject>Values</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1982</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kEtLAzEUhYMotVZ_gQgBwY2M3jxmkiylVq3U2kW7HjLThKbMy8kM0n9vpMWFiHdz4dzvHC4HoUsCdwTi5H4-eX0jSlKQNGEgQAE5QkMSMxZxDskxGgJQGXGh2Ck6834LYQhXAzQIsKKUDtF8XLjK5brAK29wbXG3MXha-T7IYdveu7rCi75scBAIAF7ozpmq8_jTdRu83DWBx49OZ6Yz_hydWF14c3HYI7R6mizHL9Hs_Xk6fphFOQfSRVwxvhZA10CFMFKaDJjmJs8yKmMlFFe5JjSG3CqpjCKJsEmSSKtzGxNKgI3QzT63aeuP3vguLZ3PTVHoytS9TwUnlApKA3j9C9zWfVuF31IiAyAEEXGg2J7K29r71ti0aV2p211KIP3uOv2j6-C6OmT3WWnWP55DueF-u7-XpU8rsy3_TfsCNdCCJQ</recordid><startdate>19820826</startdate><enddate>19820826</enddate><creator>Mecklenburg, Robert S</creator><creator>Benson, James W</creator><creator>Becker, Nancy M</creator><creator>Brazel, Patricia L</creator><creator>Fredlund, Paul N</creator><creator>Metz, Robert J</creator><creator>Nielsen, Robert L</creator><creator>Sannar, Carolyn A</creator><creator>Steenrod, William J</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>19820826</creationdate><title>Clinical Use of the Insulin Infusion Pump in 100 Patients with Type I Diabetes</title><author>Mecklenburg, Robert S ; Benson, James W ; Becker, Nancy M ; Brazel, Patricia L ; Fredlund, Paul N ; Metz, Robert J ; Nielsen, Robert L ; Sannar, Carolyn A ; Steenrod, William J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c401t-4934d702d0277e88eb03a4ecbb28597949ca1250cf989e9167f6668facf512103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1982</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Blood glucose</topic><topic>Blood Glucose - analysis</topic><topic>Blood levels</topic><topic>Clinical medicine</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus - blood</topic><topic>Diabetes Mellitus - classification</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetic ketoacidosis</topic><topic>Fasting</topic><topic>Female</topic><topic>Glucose</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Hemoglobin</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Insulin</topic><topic>Insulin Infusion Systems</topic><topic>Ketoacidosis</topic><topic>Laboratories</topic><topic>Male</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Patient Acceptance of Health Care</topic><topic>Patient Education as Topic</topic><topic>Patients</topic><topic>Sugar</topic><topic>Time Factors</topic><topic>Values</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mecklenburg, Robert S</creatorcontrib><creatorcontrib>Benson, James W</creatorcontrib><creatorcontrib>Becker, Nancy M</creatorcontrib><creatorcontrib>Brazel, Patricia L</creatorcontrib><creatorcontrib>Fredlund, Paul N</creatorcontrib><creatorcontrib>Metz, Robert J</creatorcontrib><creatorcontrib>Nielsen, Robert L</creatorcontrib><creatorcontrib>Sannar, Carolyn A</creatorcontrib><creatorcontrib>Steenrod, William J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mecklenburg, Robert S</au><au>Benson, James W</au><au>Becker, Nancy M</au><au>Brazel, Patricia L</au><au>Fredlund, Paul N</au><au>Metz, Robert J</au><au>Nielsen, Robert L</au><au>Sannar, Carolyn A</au><au>Steenrod, William J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Use of the Insulin Infusion Pump in 100 Patients with Type I Diabetes</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1982-08-26</date><risdate>1982</risdate><volume>307</volume><issue>9</issue><spage>513</spage><epage>518</epage><pages>513-518</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>We investigated the efficacy of insulin-pump therapy in insulin-dependent diabetics, aged 18 to 69 years, by comparing the metabolic control achieved in 100 patients using this technique with that previously obtained by conventional insulin therapy. Patients were followed during pump therapy for as long as 15 months. Fasting and nonfasting blood glucose levels (mean ±S.E.M.) decreased from 201±6 and 213±6 mg per deciliter (11.2±0.3 and 11.8±0.3 mmol per liter), respectively, to 158±5 and 145±3 mg per deciliter (8.77±0.3 and 8.05±0.2 mmol per liter) after one month of pump therapy (P<0.001). Ninety-three patients had improved blood sugar control; 71 per cent had a mean blood sugar concentration of 150 mg per deciliter (8.3 mmol per liter) or less after six months. Glycosylated hemoglobin values became normal in 44 per cent of 88 patients who had follow-up determinations. In over 500 patient-months there were four episodes of ketoacidosis and five episodes of serious hypoglycemia. Three patients abandoned pump therapy. We conclude that insulin-pump therapy is acceptable to patients and that it can be successfully applied to clinical practice and large-scale research studies. (N Engl J Med. 1982; 307:513–8.)
OPEN-LOOP insulin-infusion pumps and home glucose monitoring have been used to achieve striking improvement in the control of diabetes in small numbers of highly supervised patients.
1
2
3
The feasibility of applying these techniques to large numbers of patients over extended periods for the purpose of investigating the relation between glycemic control and the chronic complications of diabetes has not been established. The practicality of using insulin-infusion pumps in clinical practice has been a matter of debate.
4
We have investigated the feasibility of applying these techniques to large-scale clinical research studies and to clinical practice by comparing the metabolic control attained by . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>7099222</pmid><doi>10.1056/NEJM198208263070901</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 1982-08, Vol.307 (9), p.513-518 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| subjects | Adolescent Adult Aged Blood glucose Blood Glucose - analysis Blood levels Clinical medicine Diabetes Diabetes mellitus Diabetes Mellitus - blood Diabetes Mellitus - classification Diabetes Mellitus - drug therapy Diabetes Mellitus, Type 1 - drug therapy Diabetic ketoacidosis Fasting Female Glucose Glycated Hemoglobin A - analysis Hemoglobin Humans Hypoglycemia Insulin Insulin Infusion Systems Ketoacidosis Laboratories Male Metabolism Middle Aged Patient Acceptance of Health Care Patient Education as Topic Patients Sugar Time Factors Values |
| title | Clinical Use of the Insulin Infusion Pump in 100 Patients with Type I Diabetes |
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