Download PDF
Diabetologie und Stoffwechsel 2009; 4(6): 390-397
DOI: 10.1055/s-0029-1224715
Übersicht

© Georg Thieme Verlag Stuttgart ˙ New York

Experimentelle Untersuchungen und klinische Evidenz der Insulinpumpentherapie (CSII)

Experimental Research and Clinical Evidence of Insulin Pump Therapy (CSII)H. R. Henrichs1 , A. Liebl2 , A. Reichel3 , W. Quester4 , G. Freckmann5 , E.-M. Fach6 , A. Thomas7 für die Arbeitsgemeinschaft Diabetologische Technologie der DDG (AGDT)
  • 1Arbeitsgemeinschaft Diabetologische Technologie der DDG (AGDT), Quakenbrück
  • 2m & i-Fachklinik Bad Heilbrunn, Diabeteszentrum / Abteilung Innere Medizin, Bad Heilbrunn
  • 3Universitätsklinikum Carl Gustav Carus Dresden an der TU Dresden, Insulinpumpenambulanz, Dresden
  • 4Diabeteszentrum Bad Oeynhausen, Herz- und Diabeteszentrum Nordrhein-Westfalen, Ruhr-Universität Bochum
  • 5Institut für Diabetes-Technologie an der Universität Ulm, Ulm
  • 6Diabetologische Schwerpunktpraxis, Rosenheim
  • 7Medtronic GmbH, Geschäftsbereich Diabetes, Meerbusch
Further Information

Publication History

Publication Date:
27 November 2009 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Die Insulinpumpentherapie (Continuierliche Subcutane Insulin Infusion – CSII) ist eine etablierte Therapieform für die Insulin-Behandlung von Patien­ten mit Typ-1-Diabetes. Eine subtile Einstellung vorausgesetzt, profitieren die Patienten nach Umstellung von der ICT / MDI[1] auf die CSII von der Verbesserung des HbA1c-Wertes und / oder der Abnahme der Hypoglykämierate. Im Weiteren ist von der verbesserten Stoffwechsel­lage eine verminderte Progredienz diabetischer Folgeerkrankungen zu erwarten. Die CSII wird ­begleitet von einer großen Anzahl experimenteller Untersuchungen. Metaanalysen von randomisierten, kontrollierten klinischen Studien belegen die therapeutische Evidenz der Insulinpumpenbehandlung. 

Abstract

Continuous subcutaneous insulin infusion (CSII) is an established way of insulin therapy for pa­tients with type 1 diabetes. After correct insulin adjustment the patients on CSII experienced an improvement of HbA1c – and / or the decreasing rate of hypoglycemic reactions. On the long term an improved metabolic situation will lead to a ­reduction of long-term diabetic complications. The CSII has been studied in many experimental investigations. Meta-analyses of clinical trials have proved the therapeutic evidence of CSII. 

Schlüsselwörter

Typ-1-Diabetes - Insulinpumpentherapie (CSII) - Meta-Analysen - Evidenz der CSII - Hypoglykämierrate - HbA1c

Key words

type 1 diabetes - continuous subcutaneous insulin infusion (CSII) - meta-analyses - clinical evidence - rate of hypoglycemic reactions - HbA1c

1 MDI (multiple daily insulin injections), in der englischsprachigen Literatur synonym verwendet für ICT (sogenannte intensivierte conventionelle Insulintherapie)

Literatur

  • 1 Henrichs H R. Diabetestherapie mit Insulinpumpen. ISBN 3-89599-650-5; UNI-MED Verlag: 2003
    Google Scholar
  • 2 Henrichs H R. Who should access Insulin pump treatment?. IDF-TWAS-Meeting Warzaw 2006. www.idf.org/webdata/docs/Presentation%20Henrichs%20Who%20should%20access%20pump%20therapy.ppt
    Google Scholar
  • 3 Bode B. Pump therapy.  Diabetic Medicine. 2006;  23 (Suppl. 4) 426-427
    CrossrefGoogle Scholar
  • 4 Koivisto V A, Yki-Jarvinen H, Helve E et al. Pathogenesis and prevention of the dawn phenomenon in diabetic patients treated with CSII.  Diabetes. 1986;  35 78-82
    CrossrefGoogle Scholar
  • 5 Bode B W, Steed R D, Davidson P C. Reduction in severe hypoglycemia with long-term continuous subcutaneous insulin infusion in type 1 diabetes.  Diabetes Care. 1996;  19 324-327
    CrossrefGoogle Scholar
  • 6 Aragona M, Giannarelli R, Coppelli A et al. Improvement of retinopathy in Type 1 diabetic patients treated with continuous subcutaneous insulin infusion (CSII).  Diabetes Metabol. 2003;  29 235
    Google Scholar
  • 7 Lüddeke H J, Hofmann W, Guder W G et al. Urinary albumin concentration in 52 CSII treated type 1 diabetic patients during a follow-up of 4 years.  Diabetes und Stoffwechsel. 2002;  11 (Suppl. 1) 115
    Google Scholar
  • 8 Linkeschova R, Raoul M, Bott U et al. Less severe hypoglycaemia, better metabolic control, and improved quality of life in Type 1 diabetes mellitus with continuous subcutaneous insulin infusion (CSII) therapy; an observational study of 100 consecutive patients followed for a mean of 2 years.  Diabetic Medicine. 2002;  19 746-751
    CrossrefGoogle Scholar
  • 9 Doyle E A, Weinzimer S A, Steffen A T et al. A randomized, prospective trial comparing the efficacy of continuous subcutaneous insulin infusion with multiple daily injection using insulin Glargine.  Diabetes Care. 2004;  27 1554-1558
    CrossrefGoogle Scholar
  • 10 Vortherms J, Klinkert C, Lotz N et al. Insulinpumpentherapie bei Kindern und Jugendlichen mit schwerwiegenden Verhaltensauffälligkeiten.  Diabetes und Stoffwechsel. 2001;  10 (Suppl. 1) 56
    Google Scholar
  • 11 Knight S, Northam E, Donath S et al. Improvements in cognition, mood and behaviour following commencement of continuous subcutane­ous insulin infusion therapy in children with type 1 diabetes mellitus: a pilot study.  Diabetologia. 2009;  52 193-198
    CrossrefGoogle Scholar
  • 12 Danne T, Lange K, Kordonouri O. New developments in the treatment of type 1 diabetes in children.  Arch Dis Child. 2007;  92 1015-1019
    CrossrefGoogle Scholar
  • 13 Holder M, Ludwig-Seibold C, Lilienthal E für die DPV-Wiss-Initiative et al. Trends in der Insulinpumpentherapie bei Kindern, Jugendlichen und jungen Erwachsenen mit Typ-1-Diabetes von 1995–2006: Daten der DPV-Initiative.  Diabetologie & Stoffwechsel. 2007;  2 169-174
    Article in Thieme ConnectGoogle Scholar
  • 14 Pickup J, Sutten A J. Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion.  Diabetic Medicine. 2008;  25 765-774
    CrossrefGoogle Scholar
  • 15 Jeitler K, Horvath K, Berghold A et al. Continuous subcutaneous insulin infusion versus multiple daily insulin injections in patients with diabetes mellitus: systematic review and meta-analysis.  Diabetologia. 2008;  51 941-951
    CrossrefGoogle Scholar
  • 16 NICE CSII Guidance TA151 .Continuous subcutaneous insulin infusion for the treatment of diabetes mellitus. Review of technology appraisal guidance 57, Issue Date July 2008: http://www.nice.org.uk/ta151
    Google Scholar
  • 17 Hoogma R PL, Hammond P J, Gomis R on behalf of the 5-Nations Study Group et al.,. Comparison of the effects continuous subcutaneous insulin infusion (CSII) and NPH-based multiple daily insulin injections (MDI) on glycaemic control and quality of life: results of the 5-nations trial.  Diabetes Medicine. 2005;  23 141-147
    Google Scholar
  • 18 Weissberg-Benchell J, Antisdel-Lomaglio J, Seshadri R. Insulin pump therapy: a meta-analysis.  Diabetes Care. 2003;  26 1079-1087
    CrossrefGoogle Scholar
  • 19 Pickup J, Keen H. Continuous subcutaneous insulin infusion at 25 years: Evidence base for the expanding use of insulin pump therapy in type 1 diabetes.  Diabetes Care. 2002;  25 593-598
    CrossrefGoogle Scholar
  • 20 The Diabetes Control and Complications Trial Research Group . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.  The New England Journal of Medicine. 1993;  14 977-986
    Google Scholar
  • 21 Unger H, Henrichs H R. DCCT 1992 (Diabetes Control and Complications Trial) – Zum Stand der US-amerikanischen Großstudie über den Zusammenhang zwischen Einstellungsqualität und Diabeteskomplikationen.  Diabetes und Stoffwechsel. 1992;  1 286-289
    Google Scholar
  • 22 The Diabetes Control and Complications Trial Research Group . The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial.  Diabetes. 1995;  44 968-983
    CrossrefGoogle Scholar
  • 23 Eeg-Olofsson K, Cederholm J, Nilsson P M for the Steering Committee of the Swedish National Diabetes Register Glycemic and Risk Factor Control in Type 1 Diabetes et al.,. Results from 13 612 patients in a national diabetes register.  Diabetes Care. 2007;  30 496-502
    CrossrefGoogle Scholar
  • 24 Behre A, Ehren M, Reinsch B et al. Erste Erfahrungen mit kontinuier­lichem Glukose-Monitoring unter Klinikbedingungen.  Diabetes und Stoffwechsel. 2001;  10 (Suppl. 1) 126
    Google Scholar
  • 25 Pickup J, Mattock M, Kerry S. Glycaemic control with continuous subcutaneous insulin infusion compared with intensive insulin injections in patients with type 1 diabetes: meta-analysis of randomized controlled trials.  BMJ. 2002;  324 1-6
    CrossrefGoogle Scholar
  • 26 Kilpatrick E S, Rigby A S, Atkin S L. The effect of glucose variability on the risk of microvascular complications in type 1 diabetes.  Diabetes Care. 2006;  29 1486-1490
    CrossrefPubMedGoogle Scholar
  • 27 Monnier L, Mas E, Ginet C et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes.  JAMA. 2006;  295 1681-1687
    CrossrefPubMedGoogle Scholar
  • 28 Monnier L, Colette C, Leiter L et al. The effect of glucose variability on the risk of microvascular complications in type 1 diabetes.  Diabetes Care. 2007;  30 185-186
    Google Scholar
  • 29 The Diabetes Research in Children Network (DirecNet) Study Group . The effect of glucose variability on the risk of microvascular complications in type 1 diabetes.  Diabetes Care. 2007;  30 185
    Google Scholar
  • 30 Hirsch I B, Brownlee M. Should minimal blood glucose variability become the gold standard of glycemic control?.  Journal of Diabetes and Its Complications. 2005;  19 178-181
    CrossrefGoogle Scholar
  • 31 Ceriello A, Kumar S, Piconi L et al. Simultaneous control of hyperglycemia and oxidative stress normalizes endothelial function in type 1 diabetes.  Diabetes Care. 2007;  30 649-654
    CrossrefGoogle Scholar
  • 32 Wentholt I ME, Kulik W, Michels R PJ et al. Glucose fluctuations and activation of oxidative stress in patients with type 1 diabetes.  Diabetologia. 2008;  51 183-190
    Google Scholar
  • 33 The Diabetes Control and Complications Trial Research Group . Hypoglycemia in the Diabetes Control and Complications Trial.  Diabetes. 1997;  46 271-286
    CrossrefPubMedGoogle Scholar
  • 34 Retnakaran R, DeVries H J, Hanaire-Broutin H et al. Continuous subcutaneous insulin infusion versus multiple daily injections.  Diabetes Care. 2005;  28 1835-1836
    CrossrefGoogle Scholar
  • 35 Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen K F et al. Rapid tight­ening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study.  BMJ. 1985;  290 811-815
    CrossrefGoogle Scholar
  • 36 Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen K F. Effect of near normoglycaemia for two years on progression of early diabetic retinopathy, nephropathy, and neuropathy: the Oslo study.  BMJ. 1986;  293 1195-1199
    CrossrefGoogle Scholar
  • 37 Austenat E, Würzner M, Semmler S et al. CSII Is Superior to MDI for type 1 diabetes under real world conditions in clinical endpoints.  Diabetes. 2006;  55 (Suppl. 1) A 459
    Google Scholar
  • 38 Lauritzen T, Pramming S, Deckert T et al. Pharmacokinetics of continuous subcutaneous insulin infusion.  Diabetologia. 1983;  24 326-329
    Google Scholar
  • 39 Heise T, Nosek L, Biilmann Ronn B et al. Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes.  Diabetes. 2004;  53 1614-1620
    CrossrefGoogle Scholar
  • 40 Chase H P, Saib S Z, MacKenzie T et al. Post-prandial glucose excursions following four methods of bolus insulin administration in subjects with Type 1 diabetes.  Diabetic Medicine. 2002;  19 317-321
    CrossrefGoogle Scholar
  • 41 Lee M S, Cao M, Sajid A et al. The dual-wave bolus feature in CSII controls prolonged post-prandial hyperglycemia better than standard bolus in type 1 diabetes.  Diabetes. 2003;  52 (Suppl. 1) A 138
    Google Scholar
  • 42 Jones S M, Quarry J L, Caldwell-McMillan M et al. Optimal insulin pump dosing and postprandial glycemia following a pizza meal using the continuous glucose monitoring system.  Diabetes Technology & Therapeutics. 2005;  7 233-240
    Google Scholar
  • 43 O’Connell M A, Gilbertson H R, Donath S M et al. Optimizing postprandial glycemia in pediatric patients with type 1 diabetes using insulin pump therapy.  Diabetes Care. 2008;  31 1491-1495
    CrossrefGoogle Scholar
  • 44 Pankowska E, Szypowska A, Lipka M et al. Three kind of mealtime insulin administration and metabolic control in diabetic children on insulin pumps.  Diabetologia. 2008;  51 (Suppl. 1) 381
    Google Scholar
  • 45 Morrison G, Purewal T S, Weston P J. Intensive management with CSII can prevent hospital admissions of patients with gastroparesis.  Diabetologia. 2006;  49 (Suppl. 1) 677-678
    Google Scholar
  • 46 Gross T M, Kayne D, King A et al. A bolus calculator is an effective means of controlling postprandial glycemia in patients on insulin pump therapy.  Diabetes Technology & Therapeutics. 2003;  5 365-369
    CrossrefGoogle Scholar
  • 47 Shashaj B, Busetto E, Sulli N. Benefits of a bolus calculator in pre- and postprandial glycaemic control and meal flexibility of paediatric patients using continuous subcutaneous insulin infusion (CSII).  Diabetic Medicine. 2008;  25 1036-1042
    CrossrefGoogle Scholar
  • 48 Jankovec Z. Frequency of available insulin pump functions use by patients with diabetes mellitus. 1st ATTD Meeting, Prague 2008: Proceedings 112
    Google Scholar
  • 49 Liebl A, Krinelke L. Long-term results of insulin pump therapy (CSII) in adolescents and adults with type 1 diabetes mellitus in Germany.  Diabetologia Polska. 2003;  10 179-185
    Google Scholar
  • 50 Zinman B, Chiasson J L, Tildesley H et al. Insulin lispro in CSII: results of a double-blind crossover study.  Diabetes. 1997;  46 440-443
    CrossrefGoogle Scholar
  • 51 Bode B W, Steed R D, Davidson P C. Continuous subcutaneous insulin ­infusion (CSII): a study comparing lispro to regular human insulin.  Diabetes. 1997;  46 (Suppl.) A 167
    Google Scholar
  • 52 Renard E, Vague V, Pinget M et al. SC Infusion of insulin Lispro vs regular insulin by portable pumps: significant improvement of HbA1c and blood glucose stability under insulin Lispro.  Diabetes. 1997;  46 (Suppl. 1) 419
    Google Scholar
  • 53 Reichel A, Rietzsch H, Köhler H J et al. Cessation of insulin infusion at night-time during CSII-therapy: comparison of regular human insulin and insulin lispro.  Exp Clin Endocrinol Diabetes.. 1998;  106 168-172
    Article in Thieme ConnectGoogle Scholar
  • 54 Guerci B, Meyer L, Salle A S et al. Comparison of metabolic deterioration between insulin analog and regular insulin after a 5-hour interrup­tion of a continuous subcutaneous insulin infusion in type 1 diabetic ­patients.  Journal of Clinical Endocrinology & Metabolism. 1999;  84 2673-2678
    CrossrefGoogle Scholar
  • 55 Schartmann U, Larbig M, Schone E et al. 3-Hydroxybutyrate monitoring by means of a hand-held device after interruption of insulin pump therapy.  Diabetologia. 2000;  43 (Suppl. 1) A 208
    Google Scholar
  • 56 Attila N, Holcombe J, Jones T W et al. Comparison of human regular and Lispro insulins after interruption of continuous subcutaneous insulin infusion and in the treatment of acutely decompensated IDDM.  Diabetes Care. 1998;  21 817-821
    CrossrefGoogle Scholar
  • 57 Renner R, Pfutzner A, Trautmann M et al. Use of insulin lispro in continuous subcutaneous insulin infusion treatment. Results of a multicenter trial. German Humalog – CSII Study Group.  Diabetes Care. 1999;  22 784-788
    CrossrefGoogle Scholar
  • 58 Colquitt J, Royle P, Waugh N. Are analogue insulins better than soluble in continuous subcutaneous insulin infusion? Results of a meta-analysis.  Diabetic Medicine. 2003;  20 863-866
    CrossrefGoogle Scholar
  • 59 Schmauss S, König A, Landgraf R. Human insulin analogue [LYS(B28), PRO(B29)]: the ideal pump insulin?.  Diabet Med. 1998;  15 247-249
    CrossrefGoogle Scholar
  • 60 Linkeschova R, Spraul M, Jatzkowski E et al. Quality of life, treatment ­satisfaction and diabetes control on insulin Lispro and regular human insulin during CSII: a randomised double-blind crossover study.  Diabetes Metabol. 2003;  29 226
    Google Scholar
  • 61 Schäfermeyer M T, Jatzkowksi E, Linkeschova R et al. Insulinpumpentherapie mit Insulin Lispro versus Normalinsulin bei Diabetes mellitus Typ 1 – Doppelblinde Cross-over-Studie unter Einbeziehung des ContinuousGlucose Monitoring System (CGMS).  Diabetologie. 2006;  1 137
    Google Scholar
  • 62 Bode B W, Weinstein R, Bell D et al. Comparison of insulin Aspart with buffered regular insulin and insulin Lispro in continuous subcutaneous insulin infusion.  Diabetes Care. 2002;  25 439-444
    CrossrefGoogle Scholar
  • 63 Hanaire-Broutin H, Schumiki D-M, Hoogma R PLM et al. Safety of insulin Glulisine compared with insulin Aspart administered by continuous subcutaneous insulin infusion (CSII).  Diabetes. 2004;  53 (Suppl. 2) A4
    CrossrefGoogle Scholar
  • 64 Lepore G, Dodesini A R, Nosari I et al. Both continuous subcutaneous ­insulin infusion and a multiple daily insulin injection regimen with Glargine as basal insulin are equally better than traditional multiple daily insulin injection treatment.  Diabetes Care. 2003;  26 1321-1324
    CrossrefGoogle Scholar
  • 65 Lepore G, Dodesini A R, Nosari I et al. Effect of continuous subcutaneous insulin infusion vs multiple daily insulin injection treatment.  Diabetes Metab. 2004;  17 84-89
    Google Scholar
  • 66 Bolli G, Capani F, Home P D et al. Comparison of a multiple daily injection regimen with once-daily insulin Glargine basal insulin and mealtime Lispro, to continuous subcutaneous insulin infusion: a ran­domised, open, parallel study.  Diabetes. 2004;  53 (Suppl. 2) A107
    Google Scholar
  • 67 Pickup J C, Kidd J, Burmiston D et al. Effectiveness of continuous sub­cutaneous insulin infusion in hypoglycaemia-prone type 1 diabetes.  Practical Diabetes International. 2005;  22 10-14
    CrossrefGoogle Scholar
  • 68 The EQuality1 Study Group . Quality of life and treatment satisfaction in adults with Type 1 diabetes: a comparison between continuous sub­cutaneous insulin infusion and multiple daily injections.  Diabetic Medicine. 2008;  25 213-220
    CrossrefGoogle Scholar
  • 69 Schottenfeld-Naor Y, Galatzer A, Karp M et al. Comparison of metabolic and psychological parameters during continuous subcutaneous insulin infusion and intensified conventional insulin treatment in type I diabetic patients.  Isr J Med Sci. 1985;  21 822-828
    Google Scholar
  • 70 Shapiro J, Wigg D, Charles M A et al. Personality and family profiles of chronic insulin-dependent diabetic patients using portable insulin ­infusion pump therapy: a preliminary investigation.  Diabetes Care. 1984;  7 137-142
    CrossrefGoogle Scholar
  • 71 Boland E A, Grey M, Oesterle A et al. 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.  Diabetes Care. 22;  1999 1779-1784
    Google Scholar
  • 72 Herman W H, Ilag L L, Johnson S L et al. Clinical trial of continuous sub­cutaneous insulin infusion versus multiple daily injections in older adults with type 2 diabetes.  Diabetes Care. 2005;  28 1568-1573
    CrossrefGoogle Scholar
  • 73 Edelman S V, Bode B W, Bailey T S et al. Continuous subcutaneous insulin infusion in patients with type 2 diabetes safely improved glycemic ­control using a simple insulin dosing regimen.  Diabetes. 2009;  58 (Suppl. 1) A113
    Google Scholar
  • 74 Li Y, Xu W, Liao Z, Chen X et al. Induction of long-term glycemic control in newly diagnosed type 2 diabetic patients is associated with improvement of β-cell function.  Diabetes Care. 2004;  27 2597-2602
    CrossrefPubMedGoogle Scholar
  • 75 Choi S B, Lee S M, Kim D Y et al. Changes in adipokine profiles in type 2 diabetics treated with long-term continuous subcutaneous insulin ­infusion.  Diabetes. 2006;  55 (Suppl. 1) A 97
    Google Scholar
  • 76 Jankovec Z, Cechurova D, Krcma M et al. The influence of insulin pump treatment on metabolic syndrome parameters in type 2 diabetic patients.  Diabetes. 2006;  55 (Suppl. 1) A 142-A 143
    Google Scholar
  • 77 Hanefeld M, Fischer S, Julius U et al. Risk factors for myocardial infarction and death in newly detected NIDDM: the Diabetes Interventional Study, 11-year follow-up.  Diabetologia. 1996;  39 1577-1583
    CrossrefGoogle Scholar
  • 78 Chen H-S, Hsiao L-C, Wu T-E et al. Beneficial effects of insulin on glycem­ic control and β-cell function in newly diagnosed type 2 diabetes with severe hyperglycemia after short-term intensive insulin therapy.  Diabetes Care. 2008;  31 1927-1932
    CrossrefGoogle Scholar
  • 79 Ilkova H, Glaser B, Tunckale A et al. Induction of long-term glycemic control in newly diagnosed type 2 diabetic patients by transient intensive insulin treatment.  Diabetes Care. 1997;  20 1353-1356
    CrossrefPubMedGoogle Scholar
  • 80 Noh Y-H, Lee J-H, Lee J-H et al. Long-term continuous subcutaneous ­insulin infusion treatment improved insulinogenic index and proinsulin-to-insulin ratio in longstanding type 2 diabetic patients.  Diabetes. 2009;  58 (Suppl. 1) A61
    CrossrefGoogle Scholar
  • 81 Zhang B, Chen Y, Yang Z et al. The role of acute glucagon response in long-term remission of newly-diagnosed type 2 diabetes induced by short-term insulin intensive treatment.  Diabetes. 2009;  58 (Suppl. 1) A62
    Google Scholar
  • 82 Raskin P, Bode B W, Marks J B et al. Continuous subcutaneous insulin infusion and multiple daily injection therapy are equally effective in type 2 diabetes. A randomized, parallel-group, 24-week study.  Diabetes Care. 2003;  26 2598-2603
    CrossrefGoogle Scholar
  • 83 The ACCORD Study Group . Effects of intensive glucose lowering in type 2 diabetes.  N Engl J Med. 2008;  358 2545-2559
    CrossrefGoogle Scholar
  • 84 Gill G V, Woodward A, Casson I F et al. Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes – the ‘dead in bed’ syndrome revisited.  Diabetologia. 2009;  52 42-45
    CrossrefGoogle Scholar
  • 85 Sozialmedizinische Expertengruppe .„Versorgungsstrukturen“ (SEG-3) der MDK-Gemeinschaft Sozialmedizinische Stellungnahme zur Behandlung des Diabetes mellitus mit externen Insulinpumpen. April 2006
    Google Scholar
  • 86 Halvorson M, Carpenter S, Kaiserman K et al. A Pilot trial in pediatrics with the sensor-augmented pump: combining real-time continuous glucose monitoring with the insulin pump.  J Pediatr. 2007;  150 103-105
    Google Scholar
  • 87 Petrovski G, Dimitrovski C, Milenkovic T. Insulin pump therapy with continuous glucose monitoring improves metabolic control in brittle type 1 diabetes.  Prilozi Odd Biol Med Nauki. 2008;  28 129-135
    Google Scholar
  • 88 Hirsch I B, Abelseth J, Bode B W et al. Sensor-augmented insulin pump therapy: results of the first randomized treat-to-target study.  Diabetes Technology & Therapeutics. 2008;  10 377-383
    Google Scholar
  • 89 The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group . Continuous glucose monitoring and intensive treatment of type 1 diabetes.  NEJM. 2008;  359 1464-1476
    CrossrefGoogle Scholar
  • 90 Buckingham B A, Cobry E, Clinton P et al. Preventing hypoglycemia using predictive alarm algorithms and insulin pump suspension.  Diabetes Technology & Therapeutics. 2009;  11 93-97
    Google Scholar

1 MDI (multiple daily insulin injections), in der englischsprachigen Literatur synonym verwendet für ICT (sogenannte intensivierte conventionelle Insulintherapie)

Prof. Dr. med. H. R. Henrichs

Wilhelmstr. 7

49610 Quakenbrück

Email: hrhenrichs@t-online.de

      >