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[IP] Improved Control of Type ! with Pump in Rural Hospital Setting :-)

Abstract #:
1550 Abstract Category:Clinical Diabetes, Therapeutics/New Technology 

Improved Control of Type 1 Diabetes with Insulin Pump Therapy in a Rural 
Hospital Setting 

David M Gorson*, Lynn Hurley, Pat Carpenter, Southwestern Vermont 
Medical Center, Bennington, VT 

In 1995 we began using the insulin pump for Type 1 diabetic patients. 
Over the subsequent three years, a total of 31 patients were started on 
pump therapy. All patients were instructed by one of two certified 
diabetes nurse educators in a 50 bed rural hospital outpatient setting. 
Ten-fifteen hours of instruction was required per patient. Each patient 
wore for several days a saline "sham pump" prior to instituting insulin 
pump therapy. Complications included two skin site infections. One 
required I&D, while the other required po antibiotic therapy only. There 
were two episodes of mild DKA requiring overnight hospital stays, with 
one of those related to inappropriate dosing of insulin related to 
ethanol consumption. DKA was otherwise averted by close followup of 
patients, including 24 hour/day availability by one of the CDE's. No 
patient discontinued pump therapy. There were no emergency room visits 
for hypoglycemia, nor did any patient require administration of 
glucagon. HbA1c values for the 31 patients are as follows (normal values 
4.2-6.3%): Conclusion: insulin pump therapy promotes improved glycemic 
control in Type 1 diabetes as indicated by a statistically significant 
improvement in HbA1c values. The p value at 12 months was just beyond 
statistical significance (0.07). Data regarding self assessed changes in 
quality of life scores for these patients is being collected. 
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