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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EGlycemic control improved with a surgically implanted pump for intraperitoneal insulin infusion and proved to be superior to that of subcutaneous insulin administration. Patients also showed an improved quality of life and increased patient satisfaction with this pump, despite having to undergo an initial surgical procedure.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ehyperglycemia\/hypoglycemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Einsulin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eendocrinology\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EGlycemic control improved with a surgically implanted pump for intraperitoneal insulin infusion and proved to be superior to that of subcutaneous insulin administration. As presented at EASD by Susan Logtenberg, MD, Diabetes Centre, Isala Clinics, Zwolle, The Netherlands, patients also showed an improved quality of life and increased patient satisfaction with this pump, despite having to undergo an initial surgical procedure.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EIn type 1 diabetes, the treatment ideal is strict glycemic control. This requires not only vigilance on the part of the health care provider but also a consistent, constant effort on the part of the patient. Despite these combined efforts, glycemic targets often are not met. For such patients, an alternative could be the use of an implantable insulin pump.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EA study by Dr. Logtenberg and colleagues compared the effects of continuous intraperitoneal insulin infusion (CIPII) with an implantable pump (MIP 2007C, Medtronic) versus subcutaneous insulin (SC) infusion, either with multiple daily injections or continuous subcutaneous insulin infusion, in a population of 24 poorly controlled type 1 diabetes patients (HbA1c \u0026gt;7.5% or \u22655 hypoglycemic events\/week) in a 16-month, open-label, randomized, crossover investigation. Study endpoints were incidence of hypoglycemia (\u0026lt;4.0 mmol\/L), HbA1c, and time spent in euglycemia, as measured by a continuous glucose monitoring system.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EAll study participants had been diagnosed as having type 1 diabetes with a mean duration of more than 20 years, a baseline average HbA1c of 8.6%, and an average of 4 hypoglycemic events per week. Most patients were being maintained with continuous subcutaneous insulin infusion at study inception.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EResults showed a superior HbA1c level at 6 months for the CIPII cohort as compared with SC (7.5% vs 8.4%; p=0.02). There was a trend toward fewer hypoglycemic events, with a 13% and 16% decrease in grade 1 and 2 events (glucose \u0026lt;3.5 mmol\/L; p=0.07), respectively, with CIPII as compared with SC. The treatment effect of CIPII was strikingly improved as compared with SC in terms of time spent in euglycemia (p=0.002) and hyperglycemia (p=0.03).\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EIn a separate poster presentation (#1107), the same patient cohort was assessed for health-related quality of life (HRQOL) and treatment satisfaction. HRQOL was assessed using the SF-36 and WHO-5 instruments (range 0\u2013100), and satisfaction was gauged with the diabetes treatment satisfaction questionnaire (DTSQ; range 0\u201336). Assessments were made at baseline and at the end of treatment-crossover intervals.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EResults showed that scores for CIPII were significantly higher in 6 of the 8 subscales. The Mental and the Physical component summary scores of the SF-36 also were higher with IP (p=0.005 and p=0.02, respectively). Mean difference in DTSQ score at the end of treatment was 9.3, favoring CIPII (p=0.0004). WHO-5 score also was significantly improved as compared with SC.\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003ETaken together, these 2 datasets show that CIPII, as compared with SC, improves HbA1c levels, increases time in euglycemia, decreases time in hyperglycemia, and is reported by diabetes patients as improving their lives. Yet, as pointed out by Dr. Logtenberg, this approach, available worldwide for over 20 years, primarily is used in only France, Sweden, and The Netherlands.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2008 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/8\/7\/34.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmcjp\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}