This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Riley, W. J. Articles by McCallum, M. H. Search for Related Content PubMed PubMed Citation Articles by Riley, W. J. Articles by McCallum, M. H. Social Bookmarking                         What's this?

Ambulatory Diabetes Management with Pulsed Subcutaneous Insulin Using a Portable Pump

Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, Florida

Janet H. Silverstein

Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, Florida

Arlan L. Rosenbloom

Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, Florida

Rebecca Spillar

Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, Florida

Martha H. McCallum

Division of Endocrinology, Department of Pediatrics, University of Florida, Gainesville, Florida

A portable pump, programmed to administer intermittent pulses of insulin subcutaneously, supplemented by premeal boluses, was used by 8 patients for periods up to 12 months. Two boys, 11 and 16 years of age, sought improved growth; four young adults age 19 to 26 years desired normalization of metabo lism to forestall microvascular complications already manifest; a 14-year-old girl had been incapacitated by unstable diabetes and a 26-year-old woman had been unable to attain sufficient control to gain weight without developing hypoglycemia. Maximal possible control with conventional insulin administra tion was attempted prior to pump use and such control was measured by glycohemoglobin (HgbA₁) percentage and urine and blood sugar levels during a 24-hour period and compared with control with pump use. All initially had marked reduction in 24-hour urine volume (mean 3.3 L ± 4 SEM to 1.4 ± 0.2), urine glucose (mean 198 g ± 81 to 14 ± 4) and glycemia (mean 258 mg/dl ± 29 to 133 ± 12). HgbA₁% declined markedly in all but the 14-year-old girl over the first weeks and reached normal or near normal levels in three patients. Four patients continued to use the pump after 3.5 to 12 months because of improved sense of well being, weight control, and in one, marked reduction in proteinuria. Both boys had a doubling of growth pace. Four patients are no longer using the pump after 3 to 8 months because of incon venience, manipulation with intermittent usage, intolerance of normoglycemia, or overzealous control attempts with dangerous hypoglycemia. Pump use may permit the attainment of levels of control previously not possible, but is extremely demanding for patients and health personnel and must remain an experimental method in carefully selected and monitored patients.

Clinical Pediatrics, Vol. 19, No. 9, 609-614 (1980)
DOI: 10.1177/000992288001900907


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. A. KAPLAN, B. M. LIPPE, C. R. BRINKMAN III, M. B. DAVIDSON, and M. E. GEFFNER Diabetes Mellitus Ann Intern Med, May 1, 1982; 96(5): 635 - 649. [Abstract] [PDF]