ppt课件-let’sgetpumped!basicsofcontinuoussubcutaneousinsulin.pptVIP

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ppt课件-let’sgetpumped!basicsofcontinuoussubcutaneousinsulin.ppt

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ppt课件-let’sgetpumped!basicsofcontinuoussubcutaneousinsulin

Basics of Continuous Subcutaneous Insulin Infusion Therapy Thomas Repas D.O. Diabetes, Endocrinology and Nutrition Center, Affinity Medical Group, Neenah, Wisconsin Member, Inpatient Diabetes Management Committee, St. Elizabeth’s Hospital, Appleton, WI Member, Diabetes Advisory Group, Wisconsin Diabetes Prevention and Control Program Overview History of insulin pumps Benefits of improved glycemic control Advantages of insulin pump therapy Indications for pump therapy Beginning insulin pump therapy (basal and bolus dosing) Carbohydrate Counting Hypoglycemia and hyperglycemia prevention Conclusions History of Pumps Best and Banting Evolution of Diabetes Management Technologies First Insulin Pump (early 1970s) AutoSyringe AS*6c1979-1980 Lilly Betatron 1983 How Diabetes Specialists Treat Their Own Type 1 Diabetes Benefits of Improved Glycemic Control Potential ChronicComplications of Elevated HbA1c DCCTMicrovascular Risk Reduction With Intensive Treatment Lifetime Benefits of EffectiveIntensive Therapy (DCCT) Gain of 15.3 years of complication free living compared to conventional therapy Gain of 5.1 years of life compared to conventional therapy Additional Benefits of Improving Glycemic Control Decreased macrovascular changes Insulin is NOT atherogenic Improved wound healing Decreased infections Improved post infarct survival Minimization of oxidative damage Treatment Strategies for Diabetes:Are Patients Achieving Good Control? A1C’s in Clinical Practice Advantages of CSII The Goal of Insulin Therapy:Attempt to Mimic Normal Pancreatic Function Twice-daily Split-mixed Regimens Basal Bolus Regimen with Glargine and Lispro Continuous Subcutaneous Insulin Infusion Pharmacokinetics of CSII vs MDI Uses only immediate acting insulin More predictable absorption Uses one injection site Reduces variations in absorption Eliminates most of the subcutaneous insulin depot Closest match with physiologic needs Advantages of Pump Therapy Improved blood glucose control