Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes

favourable effects on glycaemic control and hospital stay

J H DeVries, S A Eskes, Frank J Snoek, F Pouwer, E Van Ballegooie, A J Spijker, P J Kostense, M Seubert, R. J. Heine

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life.

METHODS: Thirty-three patients were included. Glycaemic control was retrospectively assessed with HbA(1c) levels acquired before implantation, 1 year later and at long-term follow up of 58 months. Duration of hospital stay the year before and the year following first implantation was extracted from hospital records. Determinants of long-term glycaemic response were sought. Self-report questionnaires were administered at 58 months follow-up only, to assess current psychopathology and quality of life.

RESULTS: Mean HbA(1c) decreased from 10.0 +/- 2.3% to 9.0 +/- 1.8% (P = 0.039) 1 year after implantation and stabilized at 9.0 +/- 1.6% (P = 0.023) during long-term follow-up. Median number of hospital days in the 20 patients suffering from hospital admission before implantation decreased from 45 the year before implantation to 13 the year after (P = 0.005). Patients with a higher baseline HbA(1c) showed a larger long-term response (P < 0.001). Relatively low levels for quality of life were found, as well as a higher than expected number of patients with psychiatric symptoms.

CONCLUSIONS: CIPII proved effective in complex patients with a history of poor control and hospital admission. Despite a substantial long-term improvement in glycaemic control and diminished hospital stay, normal levels of glycaemic control and quality of life were not attained.

OriginalsprogEngelsk
TidsskriftDiabetic Medicine Online
Vol/bind19
Udgave nummer6
Sider (fra-til)496-501
Antal sider6
ISSN0742-3071
StatusUdgivet - jun. 2002

Fingeraftryk

Length of Stay
Insulin
Quality of Life
Hospital Records
Psychopathology
Self Report

Citer dette

DeVries, J. H., Eskes, S. A., Snoek, F. J., Pouwer, F., Van Ballegooie, E., Spijker, A. J., ... Heine, R. J. (2002). Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes: favourable effects on glycaemic control and hospital stay. Diabetic Medicine Online, 19(6), 496-501.
DeVries, J H ; Eskes, S A ; Snoek, Frank J ; Pouwer, F ; Van Ballegooie, E ; Spijker, A J ; Kostense, P J ; Seubert, M ; Heine, R. J. / Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes : favourable effects on glycaemic control and hospital stay. I: Diabetic Medicine Online. 2002 ; Bind 19, Nr. 6. s. 496-501.
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abstract = "AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life.METHODS: Thirty-three patients were included. Glycaemic control was retrospectively assessed with HbA(1c) levels acquired before implantation, 1 year later and at long-term follow up of 58 months. Duration of hospital stay the year before and the year following first implantation was extracted from hospital records. Determinants of long-term glycaemic response were sought. Self-report questionnaires were administered at 58 months follow-up only, to assess current psychopathology and quality of life.RESULTS: Mean HbA(1c) decreased from 10.0 +/- 2.3{\%} to 9.0 +/- 1.8{\%} (P = 0.039) 1 year after implantation and stabilized at 9.0 +/- 1.6{\%} (P = 0.023) during long-term follow-up. Median number of hospital days in the 20 patients suffering from hospital admission before implantation decreased from 45 the year before implantation to 13 the year after (P = 0.005). Patients with a higher baseline HbA(1c) showed a larger long-term response (P < 0.001). Relatively low levels for quality of life were found, as well as a higher than expected number of patients with psychiatric symptoms.CONCLUSIONS: CIPII proved effective in complex patients with a history of poor control and hospital admission. Despite a substantial long-term improvement in glycaemic control and diminished hospital stay, normal levels of glycaemic control and quality of life were not attained.",
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DeVries, JH, Eskes, SA, Snoek, FJ, Pouwer, F, Van Ballegooie, E, Spijker, AJ, Kostense, PJ, Seubert, M & Heine, RJ 2002, 'Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes: favourable effects on glycaemic control and hospital stay', Diabetic Medicine Online, bind 19, nr. 6, s. 496-501.

Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes : favourable effects on glycaemic control and hospital stay. / DeVries, J H; Eskes, S A; Snoek, Frank J; Pouwer, F; Van Ballegooie, E; Spijker, A J; Kostense, P J; Seubert, M; Heine, R. J.

I: Diabetic Medicine Online, Bind 19, Nr. 6, 06.2002, s. 496-501.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Continuous intraperitoneal insulin infusion in patients with 'brittle' diabetes

T2 - favourable effects on glycaemic control and hospital stay

AU - DeVries, J H

AU - Eskes, S A

AU - Snoek, Frank J

AU - Pouwer, F

AU - Van Ballegooie, E

AU - Spijker, A J

AU - Kostense, P J

AU - Seubert, M

AU - Heine, R. J.

PY - 2002/6

Y1 - 2002/6

N2 - AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life.METHODS: Thirty-three patients were included. Glycaemic control was retrospectively assessed with HbA(1c) levels acquired before implantation, 1 year later and at long-term follow up of 58 months. Duration of hospital stay the year before and the year following first implantation was extracted from hospital records. Determinants of long-term glycaemic response were sought. Self-report questionnaires were administered at 58 months follow-up only, to assess current psychopathology and quality of life.RESULTS: Mean HbA(1c) decreased from 10.0 +/- 2.3% to 9.0 +/- 1.8% (P = 0.039) 1 year after implantation and stabilized at 9.0 +/- 1.6% (P = 0.023) during long-term follow-up. Median number of hospital days in the 20 patients suffering from hospital admission before implantation decreased from 45 the year before implantation to 13 the year after (P = 0.005). Patients with a higher baseline HbA(1c) showed a larger long-term response (P < 0.001). Relatively low levels for quality of life were found, as well as a higher than expected number of patients with psychiatric symptoms.CONCLUSIONS: CIPII proved effective in complex patients with a history of poor control and hospital admission. Despite a substantial long-term improvement in glycaemic control and diminished hospital stay, normal levels of glycaemic control and quality of life were not attained.

AB - AIMS: To evaluate the effects of continuous intraperitoneal insulin infusion (CIPII) using implantable pumps on glycaemic control and duration of hospital stay in poorly controlled 'brittle' Dutch diabetes patients, and to assess their current quality of life.METHODS: Thirty-three patients were included. Glycaemic control was retrospectively assessed with HbA(1c) levels acquired before implantation, 1 year later and at long-term follow up of 58 months. Duration of hospital stay the year before and the year following first implantation was extracted from hospital records. Determinants of long-term glycaemic response were sought. Self-report questionnaires were administered at 58 months follow-up only, to assess current psychopathology and quality of life.RESULTS: Mean HbA(1c) decreased from 10.0 +/- 2.3% to 9.0 +/- 1.8% (P = 0.039) 1 year after implantation and stabilized at 9.0 +/- 1.6% (P = 0.023) during long-term follow-up. Median number of hospital days in the 20 patients suffering from hospital admission before implantation decreased from 45 the year before implantation to 13 the year after (P = 0.005). Patients with a higher baseline HbA(1c) showed a larger long-term response (P < 0.001). Relatively low levels for quality of life were found, as well as a higher than expected number of patients with psychiatric symptoms.CONCLUSIONS: CIPII proved effective in complex patients with a history of poor control and hospital admission. Despite a substantial long-term improvement in glycaemic control and diminished hospital stay, normal levels of glycaemic control and quality of life were not attained.

KW - Adult

KW - Blood Glucose

KW - Demography

KW - Diabetes Mellitus, Type 1

KW - Female

KW - Follow-Up Studies

KW - Hemoglobin A, Glycosylated

KW - Humans

KW - Infusions, Parenteral

KW - Insulin Infusion Systems

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Netherlands

KW - Patient Satisfaction

KW - Quality of Life

KW - Retrospective Studies

KW - Social Adjustment

KW - Surveys and Questionnaires

KW - Time Factors

KW - Journal Article

M3 - Journal article

VL - 19

SP - 496

EP - 501

JO - Diabetic Medicine Online

JF - Diabetic Medicine Online

SN - 1464-5491

IS - 6

ER -