Insulin infusion therapy. Potential benefits and risks.
A mass of evidence favors the concept of euglycemic management of insulin-dependent diabetes, despite significant potential complications. Patients with advanced nephropathy and/or autonomic neuropathy are very poor risks, and infusion therapy does not reverse well-established complications. To well-motivated, educated patients, infusion therapy offers the conveniences of more flexible timing of meals and of having a premeal bolus infusion rather than a premeal injection. With improvement in the technology of continuous glucose monitoring and closed-loop systems, as well as basic improvements in immunologic techniques for islet transplantation, the future may offer a choice of excellent euglycemic therapies for insulin-dependent diabetes. Meanwhile, infusion therapy, which was once only a research tool, is now widely available and is appropriate for near-euglycemic management of diabetes in selected patients.
D000038:Abscess / Q000209:etiology; D000686:Amyloidosis / Q000209:etiology; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000188:drug therapy; D016883:Diabetic Ketoacidosis / Q000209:etiology; D003928:Diabetic Nephropathies / Q000188:drug therapy; D003929:Diabetic Neuropathies / Q000188:drug therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy; D005069:Evaluation Studies as Topic; D006801:Humans; D007332:Insulin Infusion Systems / Q000009:adverse effects / Q000191:economics / Q000592:standards; D012306:Risk; D012874:Skin Diseases, Infectious / Q000209:etiology
D001786:Blood Glucose