BACKGROUND Insulin pump therapy is a real breakthrough in managing diabetes Mellitus,particularly in children. It can deliver a tiny amount of insulin and decreases the need for frequent needle injections. It also hel...BACKGROUND Insulin pump therapy is a real breakthrough in managing diabetes Mellitus,particularly in children. It can deliver a tiny amount of insulin and decreases the need for frequent needle injections. It also helps to maintain adequate and optimal glycemic control to reduce the risk of metabolic derangements in different tissues.Children are suitable candidates for pump therapy as they need a more freestyle and proper metabolic control to ensure adequate growth and development.Therefore, children and their caregivers should have proper education and training and understand the proper use of insulin pumps to achieve successful pump therapy. The pump therapy continuously improves to enhance its performance and increase its simulation of the human pancreas. Nonetheless, there is yet a long way to reach the desired goal.AIM To review discusses the history of pump development, its indications, types, proper use, special conditions that may enface the children and their families while using the pump, its general care,and its advantages and disadvantages.METHODS We conducted comprehensive literature searches of electronic databases until June 30, 2022,related to pump therapy in children and published in the English language.RESULTS We included 118 articles concerned with insulin pumps, 61 were reviews, systemic reviews, and meta-analyses, 47 were primary research studies with strong design, and ten were guidelines.CONCLUSION The insulin pump provides fewer needles and can provide very tiny insulin doses, a convenient and more flexible way to modify the needed insulin physiologically, like the human pancreas, and can offer adequate and optimal glycemic control to reduce the risk of metabolic derangements in different tissues.展开更多
Objective:To study the effect of continuous subcutaneous insulin pump infusion on glucolipid metabolism as well as inflammation and oxidative stress in placenta of patients with gestational diabetes mellitus (GDM).Met...Objective:To study the effect of continuous subcutaneous insulin pump infusion on glucolipid metabolism as well as inflammation and oxidative stress in placenta of patients with gestational diabetes mellitus (GDM).Methods:Patients with GDM who received insulin therapy between March 2013 and May 2016 were selected as the research subjects and randomly divided into multiple subcutaneous insulin injection (MSII) group and continuous subcutaneous insulin pump infusion (CSII) group. Before and after treatment, serum glucolipid metabolism as well as inflammation and oxidative stress inexes in placenta were determined respectively.Results:2 weeks and 4 weeks after treatment, FBG, 1hPBG, 2hPBG, Chemerin, Vaspin and Visfatin levels of both groups of patients were significantly lower than those before treatment and FBG, 1hPBG, 2hPBG, Chemerin, Vaspin and Visfatin levels of CSII group were significantly lower than those of MSII group;after delivery, TNF-α, IL-6, ROS and AGEs levels in placenta of CSII group were significantly lower than those of MSII group.Conclusion:Continuous subcutaneous insulin infusion can more effectively improve the glucolipid metabolism and inhibit the inflammation and oxidative stress in placenta of patients with GDM than multiple subcutaneous insulin injection.展开更多
Objective:To study the effect of insulin pump and continuous intravenous insulin on ketone body metabolism, blood gas indexes and stress state in patients with diabetic ketoacidosis. Methods:Patients with diabetic ket...Objective:To study the effect of insulin pump and continuous intravenous insulin on ketone body metabolism, blood gas indexes and stress state in patients with diabetic ketoacidosis. Methods:Patients with diabetic ketoacidosis who were treated in Meizhou Maternal and Child Heath Hospital between May 2014 and March 2017 were selected as the research subjects and randomly divided into the group A who received subcutaneous insulin infusion by insulin pump and the group B who received intravenous small-dose insulin injection by micropump. The indexes of ketone body, blood gas and stress were measured before and after treatment. Results: 12 h and 24 h after treatment, serumβ-hydroxybutyrate, MDA, NE, ACTH and Cor contents of both groups of patients were significantly lower than those before treatment while pH, HCO3- and base excess levels as well as serum SOD, GSH-Px, CAT and TAC contents were significantly higher than those before treatment, and serumβ-hydroxybutyrate, MDA, NE, ACTH and Cor contents of group A were significantly lower than those of group B while pH, HCO3- and base excess levels as well as serum SOD, GSH-Px, CAT and TAC contents were significantly higher than those of group B.Conclusion:Subcutaneous insulin infusion by insulin pump can improve ketone body metabolism, acidosis status and stress state in patients with diabetic ketoacidosis.展开更多
In order to study the pathogenesis of hypertension associated with noninsulin dependent diabetes mellitus (NIDDM), Plasma glucose, insulin levels at fasting and following an oral glucose load were measured. Na +K +pum...In order to study the pathogenesis of hypertension associated with noninsulin dependent diabetes mellitus (NIDDM), Plasma glucose, insulin levels at fasting and following an oral glucose load were measured. Na +K +pump and Ca 2+ pump activities of red blood cell membrane were also assessed. Hypertensive patients with normal or impaired glucose tolerance (NGT, or IGT) had hyperinsulinemia. Obese hypertensive patients also had hyperinsulinemia, while nonobese hypertensive patients had no hyperinsulinemia, but exhibited a delay in insulin response to oral glucose tolerance test (OGTT). In multivariate analysis, considering the factors of age, BMI and plasma glucose level, DBP were still positively related to both 30 min insulin level and IAUC, but negatively correlated to activities of Na +K +pump and Ca 2+ pump. These results demonstrated that a link between obesity, hpertension and NIDDM is the insulin resistance and/or hyperinsulinemia.展开更多
目的研究乌司他丁联合胰岛素泵对糖尿病酮症酸中毒(DKA)患者pH值纠正时间及血清硫胺素浓度的影响。方法前瞻性选取2020年1月至2022年12月北京市大兴区人民医院收治的DKA患者86例,依据随机数字表法分为联合组(n=43)、对照组(n=43)。对照...目的研究乌司他丁联合胰岛素泵对糖尿病酮症酸中毒(DKA)患者pH值纠正时间及血清硫胺素浓度的影响。方法前瞻性选取2020年1月至2022年12月北京市大兴区人民医院收治的DKA患者86例,依据随机数字表法分为联合组(n=43)、对照组(n=43)。对照组行常规治疗+胰岛素泵治疗,联合组行常规治疗+胰岛素泵+乌司他丁治疗。观察两组治疗前及治疗2周后血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)]、血清硫胺素、乳酸及二氧化碳结合力(CO_(2)CP)水平。比较两组的胰岛素用量、血糖稳定时间、血pH值纠正时间、血酮体转阴时间、尿酮体转阴时间等临床指标,比较临床疗效及不良反应发生情况。结果治疗2周后,联合组HbA1c、FPG、2 h PG分别为(6.48±0.67)%、(8.20±0.84)mmol/L、(8.43±0.86)mmol/L,均低于对照组[(7.38±0.76)%、(10.65±1.25)mmol/L、(11.39±1.32)mmol/L],差异均有统计学意义(P<0.05)。治疗2周后,联合组血清硫胺素浓度为(16.95±1.86)nmol/L,高于对照组[(13.68±1.52)nmol/L],血清乳酸及CO_(2)CP浓度分别为(3.09±0.32)、(3.42±0.36)mmol/L,均低于对照组[(4.87±0.5)、(4.39±0.45)mmol/L],差异均有统计学意义(P<0.05)。联合组胰岛素用量、血糖稳定时间、血pH值纠正时间、血酮体转阴时间、尿酮体转阴时间分别为(0.83±0.09)kg·h、(4.63±0.48)h、(35.08±3.76)h、(25.28±2.79)h、(8.48±0.87)h,均小(短)于对照组[(0.92±0.11)kg·h、(5.76±0.59)h、(42.75±4.63)h、(33.07±3.64)h、(12.96±1.51)h],差异均有统计学意义(P<0.05)。联合组治疗的总有效率为90.70%,高于对照组(69.77%),差异有统计学意义(P<0.05)。两组不良反应发生率比较(4.65%vs.9.30%),差异无统计学意义(P>0.05)。结论乌司他丁联合胰岛素泵可有效控制DKA患者血糖,缩短其pH值纠正时间,提高患者血清硫胺素浓度,疗效显著,安全性高,值得临床推广应用。展开更多
文摘BACKGROUND Insulin pump therapy is a real breakthrough in managing diabetes Mellitus,particularly in children. It can deliver a tiny amount of insulin and decreases the need for frequent needle injections. It also helps to maintain adequate and optimal glycemic control to reduce the risk of metabolic derangements in different tissues.Children are suitable candidates for pump therapy as they need a more freestyle and proper metabolic control to ensure adequate growth and development.Therefore, children and their caregivers should have proper education and training and understand the proper use of insulin pumps to achieve successful pump therapy. The pump therapy continuously improves to enhance its performance and increase its simulation of the human pancreas. Nonetheless, there is yet a long way to reach the desired goal.AIM To review discusses the history of pump development, its indications, types, proper use, special conditions that may enface the children and their families while using the pump, its general care,and its advantages and disadvantages.METHODS We conducted comprehensive literature searches of electronic databases until June 30, 2022,related to pump therapy in children and published in the English language.RESULTS We included 118 articles concerned with insulin pumps, 61 were reviews, systemic reviews, and meta-analyses, 47 were primary research studies with strong design, and ten were guidelines.CONCLUSION The insulin pump provides fewer needles and can provide very tiny insulin doses, a convenient and more flexible way to modify the needed insulin physiologically, like the human pancreas, and can offer adequate and optimal glycemic control to reduce the risk of metabolic derangements in different tissues.
文摘Objective:To study the effect of continuous subcutaneous insulin pump infusion on glucolipid metabolism as well as inflammation and oxidative stress in placenta of patients with gestational diabetes mellitus (GDM).Methods:Patients with GDM who received insulin therapy between March 2013 and May 2016 were selected as the research subjects and randomly divided into multiple subcutaneous insulin injection (MSII) group and continuous subcutaneous insulin pump infusion (CSII) group. Before and after treatment, serum glucolipid metabolism as well as inflammation and oxidative stress inexes in placenta were determined respectively.Results:2 weeks and 4 weeks after treatment, FBG, 1hPBG, 2hPBG, Chemerin, Vaspin and Visfatin levels of both groups of patients were significantly lower than those before treatment and FBG, 1hPBG, 2hPBG, Chemerin, Vaspin and Visfatin levels of CSII group were significantly lower than those of MSII group;after delivery, TNF-α, IL-6, ROS and AGEs levels in placenta of CSII group were significantly lower than those of MSII group.Conclusion:Continuous subcutaneous insulin infusion can more effectively improve the glucolipid metabolism and inhibit the inflammation and oxidative stress in placenta of patients with GDM than multiple subcutaneous insulin injection.
文摘Objective:To study the effect of insulin pump and continuous intravenous insulin on ketone body metabolism, blood gas indexes and stress state in patients with diabetic ketoacidosis. Methods:Patients with diabetic ketoacidosis who were treated in Meizhou Maternal and Child Heath Hospital between May 2014 and March 2017 were selected as the research subjects and randomly divided into the group A who received subcutaneous insulin infusion by insulin pump and the group B who received intravenous small-dose insulin injection by micropump. The indexes of ketone body, blood gas and stress were measured before and after treatment. Results: 12 h and 24 h after treatment, serumβ-hydroxybutyrate, MDA, NE, ACTH and Cor contents of both groups of patients were significantly lower than those before treatment while pH, HCO3- and base excess levels as well as serum SOD, GSH-Px, CAT and TAC contents were significantly higher than those before treatment, and serumβ-hydroxybutyrate, MDA, NE, ACTH and Cor contents of group A were significantly lower than those of group B while pH, HCO3- and base excess levels as well as serum SOD, GSH-Px, CAT and TAC contents were significantly higher than those of group B.Conclusion:Subcutaneous insulin infusion by insulin pump can improve ketone body metabolism, acidosis status and stress state in patients with diabetic ketoacidosis.
文摘In order to study the pathogenesis of hypertension associated with noninsulin dependent diabetes mellitus (NIDDM), Plasma glucose, insulin levels at fasting and following an oral glucose load were measured. Na +K +pump and Ca 2+ pump activities of red blood cell membrane were also assessed. Hypertensive patients with normal or impaired glucose tolerance (NGT, or IGT) had hyperinsulinemia. Obese hypertensive patients also had hyperinsulinemia, while nonobese hypertensive patients had no hyperinsulinemia, but exhibited a delay in insulin response to oral glucose tolerance test (OGTT). In multivariate analysis, considering the factors of age, BMI and plasma glucose level, DBP were still positively related to both 30 min insulin level and IAUC, but negatively correlated to activities of Na +K +pump and Ca 2+ pump. These results demonstrated that a link between obesity, hpertension and NIDDM is the insulin resistance and/or hyperinsulinemia.
文摘目的研究乌司他丁联合胰岛素泵对糖尿病酮症酸中毒(DKA)患者pH值纠正时间及血清硫胺素浓度的影响。方法前瞻性选取2020年1月至2022年12月北京市大兴区人民医院收治的DKA患者86例,依据随机数字表法分为联合组(n=43)、对照组(n=43)。对照组行常规治疗+胰岛素泵治疗,联合组行常规治疗+胰岛素泵+乌司他丁治疗。观察两组治疗前及治疗2周后血糖指标[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)]、血清硫胺素、乳酸及二氧化碳结合力(CO_(2)CP)水平。比较两组的胰岛素用量、血糖稳定时间、血pH值纠正时间、血酮体转阴时间、尿酮体转阴时间等临床指标,比较临床疗效及不良反应发生情况。结果治疗2周后,联合组HbA1c、FPG、2 h PG分别为(6.48±0.67)%、(8.20±0.84)mmol/L、(8.43±0.86)mmol/L,均低于对照组[(7.38±0.76)%、(10.65±1.25)mmol/L、(11.39±1.32)mmol/L],差异均有统计学意义(P<0.05)。治疗2周后,联合组血清硫胺素浓度为(16.95±1.86)nmol/L,高于对照组[(13.68±1.52)nmol/L],血清乳酸及CO_(2)CP浓度分别为(3.09±0.32)、(3.42±0.36)mmol/L,均低于对照组[(4.87±0.5)、(4.39±0.45)mmol/L],差异均有统计学意义(P<0.05)。联合组胰岛素用量、血糖稳定时间、血pH值纠正时间、血酮体转阴时间、尿酮体转阴时间分别为(0.83±0.09)kg·h、(4.63±0.48)h、(35.08±3.76)h、(25.28±2.79)h、(8.48±0.87)h,均小(短)于对照组[(0.92±0.11)kg·h、(5.76±0.59)h、(42.75±4.63)h、(33.07±3.64)h、(12.96±1.51)h],差异均有统计学意义(P<0.05)。联合组治疗的总有效率为90.70%,高于对照组(69.77%),差异有统计学意义(P<0.05)。两组不良反应发生率比较(4.65%vs.9.30%),差异无统计学意义(P>0.05)。结论乌司他丁联合胰岛素泵可有效控制DKA患者血糖,缩短其pH值纠正时间,提高患者血清硫胺素浓度,疗效显著,安全性高,值得临床推广应用。
