Abstract:
:For years, external insulin pumps have enjoyed proven efficacy as an intensive diabetes treatment to improve glycaemic control and reduce hypoglycaemia. Since the last ALFEDIAM guidelines in 1995, however, basal-bolus treatment using a combination of long- and short-acting insulin analogues have emerged and could challenge, at a lower cost, the efficacy of pumps using rapid-acting insulin analogues, considered the 'gold standard' of insulin treatment. Nevertheless, given its theoretical and practical advantages, some patients will derive more benefit from pump treatment. These cases have been carefully evaluated in the literature by a panel of experts appointed by ALFEDIAM to determine the indications for pump treatment. In patients with type 1 diabetes, persistent elevated HbA(1c) despite multiple daily injections (MDI), and repeated hypoglycaemia and high glycaemic variability, represent the most validated indications. In patients with type 2 diabetes, pump treatment may be indicated in cases of MDI failure to achieve HbA(1c) targets. Absolute contraindications are rare, and comprise severe psychiatric disorders, rapidly progressing ischaemic or proliferative retinopathy before laser treatment and exposure to high magnetic fields. Relative contraindications are mostly related to the patient's lack of compliance or inability to cope with the treatment, and need to be evaluated individually to clearly assess the benefit/risk ratio for the given patient. However, as these conditions are progressive, there should also be annual reassessment of the appropriateness of pump treatment. Specific education on pump treatment initially and throughout the follow-up, delivered by experienced medical and paramedical teams, are the best guarantees of treatment efficacy and safety.
journal_name
Diabetes Metabjournal_title
Diabetes & metabolismauthors
Lassmann-Vague V,Clavel S,Guerci B,Hanaire H,Leroy R,Loeuille GA,Mantovani I,Pinget M,Renard E,Tubiana-Rufi N,Société francophone du diabète (ex ALFEDIAM).doi
10.1016/j.diabet.2009.09.002subject
Has Abstractpub_date
2010-02-01 00:00:00pages
79-85issue
1eissn
1262-3636issn
1878-1780pii
S1262-3636(09)00253-5journal_volume
36pub_type
杂志文章,实务指引abstract::Insulin secretion from the beta-cells in the islets of Langerhans is mainly regulated by glucose entry via its transporter. The intracellular glucose metabolism induces a rise in ATP/ADP ratio which increases the degree of closure of ATP-sensitive potassium channels (K(ATP) channels), inducing a higher intracellular K...
journal_title:Diabetes & metabolism
pub_type: 评论,杂志文章,评审
doi:
更新日期:2002-12-01 00:00:00
abstract:AIM:This study aimed to assess whether group-based lifestyle counselling offered to a high-risk population subgroup had any effect beyond individual multifactorial interventions on fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) changes. METHODS:In a population-based study of 6784 participants, 4053 were de...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.diabet.2011.06.001
更新日期:2011-12-01 00:00:00
abstract::Although many heavy metals are necessary for normal biological function, a subset of heavy metals have no role in human physiology, such as lead (Pb) and arsenic (As). Such elements have deleterious effects on physiology and be associated with the incidence of diabetes and related metabolic syndromes. Haemoglobin A1c ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2021.101233
更新日期:2021-01-23 00:00:00
abstract:AIM:Kidney hypoxia can predispose to the development of acute and chronic renal failure in diabetes. Ischaemia-reperfusion injury (IRI) causes inflammation, and diabetes is known to exacerbate this inflammatory response in the kidney, whereas alarmin IL-33 could act as an innate immune mediator during kidney IRI. Thus,...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2017.06.008
更新日期:2018-02-01 00:00:00
abstract:AIM:The prevalence of diabetes in the French West Indies is three times higher than in mainland France. We aimed to assess the associations between vitamin D deficiency, vitamin D receptor (VDR) gene polymorphisms and cardiovascular risk factors in Caribbean patients with type 2 diabetes (T2D). METHODS:In this cross-s...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2011.05.005
更新日期:2011-12-01 00:00:00
abstract:AIM:Cardiovascular autonomic neuropathy (CAN) is a common but often overlooked complication of diabetes. Sympathetic C-fibers innervating sweat glands can be impaired early on in patients with diabetes. In this study, SUDOSCAN, a new non-invasive device that assesses sudomotor function was compared to methods generally...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2012.09.004
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To determine the relationship between CRP levels and the components of MS in normal glucose tolerant (NGT), impaired glucose tolerant (IGT), and Type 2 diabetic subjects. MATERIAL AND METHODS:A based cross-sectional population study was performed. Eligible subjects, men and non-pregnant women, 30 to 64 year ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70009-5
更新日期:2003-02-01 00:00:00
abstract::TNF-alpha is considered as one of the potential determinants of insulin resistance. However several data suggest that TNF-alpha expression itself, could be modulated by the degree of adiposity and/or plasma insulin levels. To clarify the determinants of plasma TNF-alpha levels in type 2 diabetes mellitus, we studied t...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:
更新日期:2000-05-01 00:00:00
abstract:AIM:Injections and fingersticks administered to patients with diabetes in health care settings present a risk of blood exposure to the injector as well as other workers in potential contact with sharps. Such exposures could lead to transmission of bloodborne pathogens such as hepatitis and HIV. A recent EU Directive re...
journal_title:Diabetes & metabolism
pub_type: 共识发展会议,杂志文章,实务指引,评审
doi:10.1016/S1262-3636(12)70975-8
更新日期:2012-01-01 00:00:00
abstract:AIMS:To evaluate the current procedures in French general practice of intensifying hypoglycaemic treatment in orally treated type 2 diabetic patients, according to the French recommendations. METHODS:Type 2 diabetic patient characteristics, HbA(1c) values, hypoglycaemic treatment and physician characteristics were col...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/S1262-3636(12)71532-X
更新日期:2012-03-01 00:00:00
abstract::Obesity and visceral or upper body fat distribution, have a major impact on insulin sensitivity. There is strong evidence to suggest that free fatty acids (FFA) contribute to the pathogenesis of insulin resistance and the metabolic syndrome. Increased FFA release from adipose tissue or failure of FFA using tissues to ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:2001-04-01 00:00:00
abstract:AIM:The aim of this study was to examine the racial and ethnic differences in the relationship between body fat distribution variables and serum lipid profiles. METHODS:Secondary data analyses were conducted on 708 healthy women (204 blacks, 247 whites and 257 Hispanics), aged 16-33 years, seen in an outpatients clini...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2010.01.010
更新日期:2010-09-01 00:00:00
abstract::The effect of propranolol on the occurrence of hypoglycaemic symptoms was assessed in insulin-dependent diabetic patients with hypoglycaemia unawareness. A double-blind, randomised parallel group study (2:1 fashion) was conducted over 4-week period. The propranolol group (n = 9) received 20 mg (week 1 and 2) and 30 mg...
journal_title:Diabetes & metabolism
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1999-03-01 00:00:00
abstract:AIM:To explore the frequency of hypoglycaemic episodes, their risk factors, and associations with patient-reported outcomes in patients with type 2 diabetes enrolled in the PANORAMA cross-sectional study. METHODS:Five thousand seven hundred and eighty-three patients aged ≥ 40 years with type 2 diabetes duration ≥ 1 ye...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2015.08.007
更新日期:2015-12-01 00:00:00
abstract::Protease inhibitor treatment has dramatically improved rates of morbidity and mortality in HIV-infected patients. However, it has recently been shown that this medication is associated with long-term side effects characterized by metabolic, clinical and biological alterations. These modifications have been described i...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:
更新日期:1999-11-01 00:00:00
abstract:CONTEXT:In 2001 the "National Cholesterol and Education Program Expert Panel" gave a clinical definition of the metabolic syndrome. The frequency of this syndrome at baseline and its incidence and persistence at three years is studied in a French population. SUBJECTS:2109 men and 2184 women from the D.E.S.I.R. longitu...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70067-8
更新日期:2003-11-01 00:00:00
abstract:AIM:In this study, we examined the trends from 1995 to 2006 in cardiovascular risk factors (CVRF) in Spaniards aged 65 years or older with diabetes. METHODS:We looked at the individual data from adults aged > or =65 years from the Spanish National Health Surveys of 1995 (n=1117), 1997 (n=1111), 2001 (n=4328), 2003 (n=...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2009.06.007
更新日期:2010-02-01 00:00:00
abstract:AIM:Bariatric surgery has been shown to effectively improve glycaemic control in morbidly obese subjects. However, the molecular bases of this association are still elusive and may act independently of weight loss. Here, our retrospective study has investigated the inflammatory molecule osteopontin (OPN) as a potential...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2018.09.007
更新日期:2019-09-01 00:00:00
abstract:AIMS:Reactive dicarbonyl compounds, such as methylglyoxal (MGO), rise during an oral glucose tolerance test (OGTT), particularly in (pre)diabetes. Fasting MGO levels are associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) in patients with poorly controlled type 2 diabetes mellitus (T2DM). Yet,...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2020.02.002
更新日期:2020-02-10 00:00:00
abstract::Insulin resistance represents a major public health problem, as it plays a major role in the pathophysiology of type 2 diabetes mellitus; it is also associated with increased cardiovascular risk and atherogenic dyslipidaemia, and is a central component of the cluster of metabolic abnormalities that comprise the metabo...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/j.diabet.2011.01.002
更新日期:2011-06-01 00:00:00
abstract::The aim of this review is to provide answers to the question “How does one screen for and diagnose gestational diabetes mellitus (GDM) between 24 and 28 weeks gestation?” Two methods are currently widely used: a one-step approach (the 75g-Oral Glucose Tolerance Test, OGTT) and a two-step approach (the 50g Glucose Chal...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/j.diabet.2010.11.008
更新日期:2010-12-01 00:00:00
abstract::To implement preventive policies of disability in older diabetic people, the role of diabetes in the disablement process should be investigated. Diabetes mellitus is consistently associated with a higher prevalence of disability at all states, as well as with a progression in disability states and may be considered as...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/s1262-3636(07)80058-9
更新日期:2007-04-01 00:00:00
abstract::Many studies have demonstrated the metabolic efficacy of continuous subcutaneous insulin infusion (CSII) and particularly a reduction of glycaemic fluctuations in type 1 diabetic patients. Despite this benefit, many patients decide to discontinue the use of CSII. To determine the factors related to discontinuation of ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/s1262-3636(07)70173-8
更新日期:2005-02-01 00:00:00
abstract:AIMS:The innate immune-receptor nucleotide oligomerization domain (NOD) protein recognizes intracellular bacterial peptidoglycan. Activation of the innate immune system contributes to the development and progression of insulin resistance. The present study aimed to determine the presence of NOD1 and NOD2 in human adipo...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2012.08.001
更新日期:2012-12-01 00:00:00
abstract::The project to finalize a 'closed loop' insulin delivery according to blood glucose level, i.e. an implanted artificial beta cell, is born from the development of the first miniaturized portable insulin pumps during the 1970s. Continuous improvements in micro-electronics, as well as in the development of biomaterials ...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:
更新日期:2002-09-01 00:00:00
abstract:AIMS:To evaluate factors associated with reaching or not reaching target glycated haemoglobin (HbA1c) levels by analysing the respective contributions of fasting hyperglycaemia (FHG), also referred to as basal hyperglycaemia, vs postprandial hyperglycaemia (PHG) before and after initiation of a basal or premixed insuli...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.diabet.2016.10.005
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare assessment of insulin sensitivity from hyperinsulinemic euglycaemic (HIEG) clamp with indexes derived from fasting and oral glucose tolerance test (OGTT). SUBJECTS AND METHODS:Cross-sectional study with 107 sedentary non-diabetic overweight and obese postmenopausal (B...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2007.02.004
更新日期:2007-09-01 00:00:00
abstract::The goal of this review is to think about how to incorporate the GLP-1 based agents, represented by the dipeptidyl peptidase-4 (DPP-4) inhibitors or the glucagon-like peptide-1 (GLP-1) analogs, in the guidelines for the management of type 2 diabetes (T2DM). Orally administered DPP-4 inhibitors, such as sitagliptin and...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/S1262-3636(08)73399-8
更新日期:2008-02-01 00:00:00
abstract::The management of type 2 diabetes continues to evolve as new data emerge. Although glycaemic control is still important, other risk factors--such as hypertension, dyslipidaemia and obesity--must also be addressed in order to reduce the long-term risks of cardiovascular complications and mortality. In this context, tar...
journal_title:Diabetes & metabolism
pub_type: 杂志文章,评审
doi:10.1016/j.diabet.2012.04.003
更新日期:2012-10-01 00:00:00
abstract:AIM:To investigate the effect of changes in fasting plasma glucose (FPG) variability, as assessed by 2-year trajectories of FPG variability, on mortality risk in patients with type 2 diabetes (T2D). METHODS:From 2009 to 2012, outpatients with T2D, aged>18 years, were enrolled from a medical centre. FPG was measured ev...
journal_title:Diabetes & metabolism
pub_type: 杂志文章
doi:10.1016/j.diabet.2017.09.001
更新日期:2018-03-01 00:00:00