title: Optimizing insulin pump therapy: the potential advantages of using a structured diabetes management program.
abstract: Use of continuous subcutaneous insulin infusion (CSII) therapy improves glycemic control, reduces hypoglycemia and increases treatment satisfaction in individuals with diabetes. As a number of patient- and clinician-related factors can hinder the effectiveness and optimal usage of CSII therapy, new approaches are needed to address these obstacles. Ceriello and colleagues recently proposed a model of care that incorporates the collaborative use of structured SMBG into a formal approach to personalized diabetes management within all diabetes populations. We adapted this model for use in CSII-treated patients in order to enable the implementation of a workflow structure that enhances patient-physician communication and supports patients' diabetes self-management skills. We recognize that time constraints and current reimbursement policies pose significant challenges to healthcare providers integrating the Personalised Diabetes Management (PDM) process into clinical practice. We believe, however, that the time invested in modifying practice workflow and learning to apply the various steps of the PDM process will be offset by improved workflow and more effective patient consultations. This article describes how to implement PDM into clinical practice as a systematic, standardized process that can optimize CSII therapy.
authors.affiliation: Department of Medical Psychology, Hannover Medical School , Hannover , Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Lange
authors.forename: Ralph
authors.initials: R
authors.lastname: Ziegler
authors.forename: Andreas
authors.initials: A
authors.lastname: Neu
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinehr
authors.forename: Iris
authors.initials: I
authors.lastname: Daab
authors.forename: Marion
authors.initials: M
authors.lastname: Walz
authors.forename: Michael
authors.initials: M
authors.lastname: Maraun
authors.forename: Oliver
authors.initials: O
authors.lastname: Schnell
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kulzer
authors.forename: Andreas
authors.initials: A
authors.lastname: Reichel
authors.forename: Lutz
authors.initials: L
authors.lastname: Heinemann
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Parkin
authors.forename: Thomas
authors.initials: T
authors.lastname: Haak
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy / Q000523:psychology; D019468:Disease Management; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects; D007332:Insulin Infusion Systems; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012648:Self Care / Q000379:methods / Q000523:psychology
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Adherence; CSII; Data management; Patient satisfaction; Personalized; SMBG