Insulin pump use in adults with type 1 diabetes--practical issues.
In recent years continuous subcutaneous insulin infusion pumps have become widely adopted in many parts of the world in the treatment of type 1 diabetes in adults. A comprehensive summary of all aspects of pump therapy is beyond the scope of this article, and in this review we will focus on several practical issues that in our experience are of clinical importance in the care of patients using insulin pumps. These include: benefits and risks of pump therapy, including the use of pumps to limit hypoglycemia; individual patient considerations in choosing between pump therapy and multiple daily injections; common pump-specific etiologies of erratic glucose control, including routine clinical practices that can assist with the detection of these problems; and the use of different pump bolus types for prandial insulin coverage.
Section of Adult Diabetes, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA.
Greeshma
G
Shetty
Howard
H
Wolpert
D000279:Administration, Cutaneous; D000328:Adult; D001288:Attention; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002755:Choice Behavior; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000469:parasitology; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control; D007279:Injections, Subcutaneous / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000523:psychology; D011788:Quality of Life
D001786:Blood Glucose; D007328:Insulin