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[IP] # of Pumpers is growing!



I get a newsletter from Medscape every once-in-a-while just to keep up on th=
e=20
studies being done.

This was in the one I received this morning...looks like there are some=20
80,000 of us pumpers in the US alone!  Our numbers are growing!  That's=20
80,000 out of approximately 1 million insulin dependent diabetics in the US=20
alone!  There has been a significant rise in the number since 1997.

The link is as the end of the article, but I don't know if you will be able=20
to access the website...I have my password.  I cut & pasted the entire=20
article below just incase you can't access the site.

Roxanne Vill=E1nueva RD, LD
Cleveland, Ohio
IDDM X 18+ years, pumping for 6+ years.
Remember...Diabetics are naturally sweet!



From
<A HREF=3D"http://diabetes.medscape.com/SMA/SMJ/public/SMJ-journal.html">Sou=
thern Medical Journal</A>=20

Reemergence of Insulin Pump Therapy in the 1990s

L. Raymond Reynolds, MD, Department of Internal Medicine, Division of=20
Endocrinology and Molecular Medicine, University of Kentucky,=20
LexingtonAbstract

The publication of the landmark Diabetes Control and Complications Trial=20
results in 1993 provided a strong impetus to achieve near-normalization of=20
blood glucose levels in type I diabetic patients using intensive insulin=20
therapy programs. Recent studies show less hypoglycemia with this form of=20
intensive therapy and equivalent or improved glycemic control. Insulin pump=20
therapy is achieving wider acceptance and application in diabetes management=
.=20
This commentary reviews the current status of insulin pump therapy, includin=
g=20
indications and future directions. [<A HREF=3D"http://diabetes.medscape.com/=
SMA/SMJ/public/archive/2000/toc-9312.html">South Med J</A> 93(12):1157-1161,=
 2000. =A9=20
2000 Southern Medical Association]

Introduction

External insulin infusion pumps became generally available in the early=20
1980s, after initial studies suggested that normalization of blood glucose=20
levels was possible in difficult-to-manage cases of insulin deficiency.[1-4]=
=20
Pump therapy was widely applied to the most difficult cases, including the=20
most unstable from a metabolic standpoint. Frequently, psychosocial problems=
=20
emerged, precluding successful therapy.[5] The results were often=20
unsatisfactory and occasionally disastrous, usually the result of unrealisti=
c=20
expectations or improper application of this technology.[6] Insulin pump=20
therapy became obscured by controversy and was used in only a small minority=
=20
of patients by the late 1980s. However, the multicenter Diabetes Control and=
=20
Complications Trial (DCCT) data showed that intensive insulin therapy=20
resulting in lower hemoglobin Alc (HbAlc) levels is associated with a=20
reduction in risk for microvascular complications.[7] The intensive therapy=20
group achieved an average reduction of 1.7% in HbAlc levels compared with th=
e=20
conventional therapy group. Patients receiving intensive therapy were treate=
d=20
either with insulin pump continuous subcutaneous insulin infusion (CSII) or=20
with multiple daily injections (MDI) of insulin, with nearly 50% receiving=20
CSII therapy during the study.[8] Adverse events associated with intensive=20
therapy included severe hypoglycemia, diabetic ketoacidosis (DKA), and weigh=
t=20
gain. Although there was a twofold to threefold greater risk for hypoglycemi=
a=20
in the intensive treatment group, the absolute incidence declined in the=20
latter years of the study. Both conventional and intensive treatment groups=20
had weight gain, and the incidence of DKA was not increased with intensive=20
therapy. Importantly, intensive therapy was not associated with a decline in=
=20
quality of life.[9] Therefore, the DCCT results prompted the American=20
Diabetes Association to recommend that blood glucose control equivalent to=20
that achieved with intensive insulin therapy be the goal for most patients=20
with type 1 diabetes.[7] In the years before the release of DCCT data,=20
insulin pump therapy was reserved primarily for an elite group of motivated,=
=20
compulsive patients, free of complications, at specialized diabetes centers.=
=20
The risk of hypoglycemia was believed to be so great that patients with=20
hypoglycemic unawareness were generally excluded from this therapy.[10] Othe=
r=20
deterrents to insulin pump therapy included concerns about patient selection=
=20
criteria, pump reliability, and an increased risk of DKA and skin=20
infections.[11-14]Studies have shown a reduced risk of hypoglycemia with pum=
p=20
therapy, with equivalent or lower HbAlc levels.[15-17] Increasing numbers of=
=20
patients are receiving this form of therapy. In 1997, a reviewer estimated=20
that 10,000 to 20,000 individuals received pump therapy.[18] Current data*=20
show a rapid growth in recent years, including approximately 80,000 pump=20
therapy patients in the United States.   =20


In a message dated 2/3/01 6:25:05 AM Eastern Standard Time,=20
email @ redacted writes:



> REEMERGENCE OF INSULIN PUMP THERAPY IN THE 1990S
> Review the current status of technology, indications, and future direction=
s.
> South Med J 93(12):1157-1161, 2000
> http://diabetes.medscape.com/33280.rhtml?srcmp=3Dendo-020201
> <A HREF=3D"http://diabetes.medscape.com/33280.rhtml?srcmp=3Dendo-020201">R=
ead
> it Here</A>
>=20
Return-path: <email @ redacted>
From: email @ redacted
Full-name: RoxanneRD
Message-ID: <email @ redacted>
Date: Sat, 3 Feb 2001 07:18:59 EST
Subject: Re: Medscape's Diabetes and Endocrinology MedPulse 02-Feb-01
  --Get Tarascon E...
To: email @ redacted
MIME-Version: 1.0
Content-Type: text/plain; charset="us-ascii"
Content-Disposition: Inline
X-Mailer: 6.0 sub 10502
X-Converted-To-Plain-Text: from multipart/alternative by demime 0.97c
X-Converted-To-Plain-Text: Alternative section used was text/plain

I get a newsletter from Medscape every once-in-a-while just to keep up on the
studies being done.

This was in the one I received this morning...looks like there are some
80,000 of us pumpers in the US alone!  Our numbers are growing!  That's
80,000 out of approximately 1 million insulin dependent diabetics in the US
alone!  There has been a significant rise in the number since 1997.

The link is as the end of the article, but I don't know if you will be able
to access the website...I have my password.  I cut & pasted the entire
article below just incase you can't access the site.

Roxanne Villanueva RD, LD
Cleveland, Ohio
IDDM X 18+ years, pumping for 6+ years.
Remember...Diabetics are naturally sweet!



From
<A
HREF="http://diabetes.medscape.com/SMA/SMJ/public/SMJ-journal.html">Southern
Medical Journal</A>

Reemergence of Insulin Pump Therapy in the 1990s

L. Raymond Reynolds, MD, Department of Internal Medicine, Division of
Endocrinology and Molecular Medicine, University of Kentucky,
LexingtonAbstract

The publication of the landmark Diabetes Control and Complications Trial
results in 1993 provided a strong impetus to achieve near-normalization of
blood glucose levels in type I diabetic patients using intensive insulin
therapy programs. Recent studies show less hypoglycemia with this form of
intensive therapy and equivalent or improved glycemic control. Insulin pump
therapy is achieving wider acceptance and application in diabetes management.
This commentary reviews the current status of insulin pump therapy, including
indications and future directions. [<A
HREF="http://diabetes.medscape.com/SMA/SMJ/public/archive/2000/toc-9312.html"
>South Med J</A> 93(12):1157-1161, 2000. )
2000 Southern Medical Association]

Introduction

External insulin infusion pumps became generally available in the early
1980s, after initial studies suggested that normalization of blood glucose
levels was possible in difficult-to-manage cases of insulin deficiency.[1-4]
Pump therapy was widely applied to the most difficult cases, including the
most unstable from a metabolic standpoint. Frequently, psychosocial problems
emerged, precluding successful therapy.[5] The results were often
unsatisfactory and occasionally disastrous, usually the result of unrealistic
expectations or improper application of this technology.[6] Insulin pump
therapy became obscured by controversy and was used in only a small minority
of patients by the late 1980s. However, the multicenter Diabetes Control and
Complications Trial (DCCT) data showed that intensive insulin therapy
resulting in lower hemoglobin Alc (HbAlc) levels is associated with a
reduction in risk for microvascular complications.[7] The intensive therapy
group achieved an average reduction of 1.7% in HbAlc levels compared with the
conventional therapy group. Patients receiving intensive therapy were treated
either with insulin pump continuous subcutaneous insulin infusion (CSII) or
with multiple daily injections (MDI) of insulin, with nearly 50% receiving
CSII therapy during the study.[8] Adverse events associated with intensive
therapy included severe hypoglycemia, diabetic ketoacidosis (DKA), and weight
gain. Although there was a twofold to threefold greater risk for hypoglycemia
in the intensive treatment group, the absolute incidence declined in the
latter years of the study. Both conventional and intensive treatment groups
had weight gain, and the incidence of DKA was not increased with intensive
therapy. Importantly, intensive therapy was not associated with a decline in
quality of life.[9] Therefore, the DCCT results prompted the American
Diabetes Association to recommend that blood glucose control equivalent to
that achieved with intensive insulin therapy be the goal for most patients
with type 1 diabetes.[7] In the years before the release of DCCT data,
insulin pump therapy was reserved primarily for an elite group of motivated,
compulsive patients, free of complications, at specialized diabetes centers.
The risk of hypoglycemia was believed to be so great that patients with
hypoglycemic unawareness were generally excluded from this therapy.[10] Other
deterrents to insulin pump therapy included concerns about patient selection
criteria, pump reliability, and an increased risk of DKA and skin
infections.[11-14]Studies have shown a reduced risk of hypoglycemia with pump
therapy, with equivalent or lower HbAlc levels.[15-17] Increasing numbers of
patients are receiving this form of therapy. In 1997, a reviewer estimated
that 10,000 to 20,000 individuals received pump therapy.[18] Current data*
show a rapid growth in recent years, including approximately 80,000 pump
therapy patients in the United States.


In a message dated 2/3/01 6:25:05 AM Eastern Standard Time,
email @ redacted writes:


> REEMERGENCE OF INSULIN PUMP THERAPY IN THE 1990S
> Review the current status of technology, indications, and future
directions.
> South Med J 93(12):1157-1161, 2000
> http://diabetes.medscape.com/33280.rhtml?srcmp=endo-020201
> <A HREF="http://diabetes.medscape.com/33280.rhtml?srcmp=endo-020201">Read
> it Here</A>
>
>
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