The complete interaction between glucose measurement and insulin administration, new challenge of pump therapy
The use of pump compared to multiple dose therapy can reduce the risk of experiencing chronic complications by up to 20%
The new intelligent infusion systems will allow insulin supply by remote control in a more discreet way
Sant Cugat del Vallés, November 23, 2009.- The objective of diabetes treatment is to achieve a glycemic adjustment as close as possible to that of a healthy pancreas.In recent years, subcutaneous infusion systems or insulin pumps have allowed this substance to be administered in a more physiological and personalized way.In this sense, new insulin bombs walk towards complete intelligence between glycemia measurement and insulin administration.
In this context, a team of professionals from the Clinic and Sant Joan de Déu hospitals in Barcelona, by the hand of Roche, have shared their experiences this weekend in a course on continuous infusion therapy subcutaneous insulin in adults and agePediatricAimed at doctors, he was attended by more than 45 doctors from Spain and Portugal involved in diabetes, with the aim of forming them in this therapy.
Pump therapy wants to remember the physiology of non -diabetic people and can, with the collaboration of medical teams, educators, and the patient itself, improve the control of this pathology in a personalized way, said Isaac Levy, consultant fromThe Functional Diabetes Unit of the Clinic Hospital in Barcelona.
Despite being one of the objectives of the National Plan against Diabetes, the implementation of ISCI in Spain is the lowest in Europe, with some 3,500 pump patients throughout the national territory.The main causes of this low implementation are the cost of the ISCI, the lack of specialized personnel and the need for continuous medical care 24 hours.
The intelligence of the new systems, revolution in therapy
The meta-analysis that compare the insulin micro-infuster therapy (ISCI) with the one based on multiple doses (MDI) indicates that hemoglobin levels improve up to half a point in the case of those pump carriers patients.This improvement seems small but can represent a 20% reduction in the appearance of chronic complications, said Dr. Levy.
Thanks to the advances achieved in the last decade, at present, the bombs are smaller, safe and easy to use thanks to the incorporation of various alarms.In addition, basal adjustments can be done with very small doses and catheters and cannulas have improved in comfort.
In this sense, in 2010, ACCU-Chek® Combo will be available in Spain, the first interactive system that will combine glucose meter and insulin pump with remote control that will make a much more discreet therapy available to patients.
With a single button, the glucometer sends the information to the infuser and it supplies the insulin without the need to handle the pump.This implies the big difference with respect to current systems, said the doctor.LevyThese advances will especially benefit patients of pediatric age, where insulin pump treatment will be increasingly frequent in the coming years, added Dr. Torres, from the Sant Joan de Déu hospital in Barcelona.
Importance of patient selection
However, the indication when prescribing the pump is fundamental for the success of the therapy.It is necessary to justify very well why a certain patient is selected in order to take advantage of their maximum possibilities and achieve a minimum abandonment rate, said Dr. Levy.
According to the consensus document of theAmerican Academy of Pediatrics In Diabetes, Insulin Pump Therapy is the administration method most similar to the physiology of the pancreas for the control of diabetes at all ages and is recommended in cases of frequent, inadvertent and serious hypoglycemia, as well as in phobias to the needles.In this sense, Dr. Marisa Torres, director of the Diabetes Unit of the San Joan de Déu Hospital in Barcelona, said that insulin bomb treatment is not urgent, the doctor has to meet the patient and her family and studyIf this system is the most appropriate for him.
