:Comparison of diabetic control between conventional treatment and continuous subcutaneous insulin infusion therapy in a pregnant diabetic in the third trimester anda brittle ambulant diabetic
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Today, the ultimate goal of diabetes care is to prevent the occurrence of diabetic complications or at least to reduce their severity. Data have been accumulated which indicate that the microangiopathy of diabetes is preventable by normalization or near-normalization of the metabolic disorders.<BR>Continuous subcutaneous insulin infusion therapy (CSII) with a portable pump appears to represent one of the best therapies at present for type I diabetes. Since there have been only a few detailed reports on long-term trials of CSII, we attempted to treat two cases of type I diabetics by CSII.<BR>Case 1 was a 33-yr-old insulin-dependent pregnant diabetic who had lost a baby 8 years previously by intrauterine fetal death at the 38th gestational week. Her diabetic control with conventional treatment became increasingly unsatisfactory in the 3rd trimester of her second pregnancy. At the 28th week of pregnancy, when her baby was endangered by fetal distress, CSII was introduced. Near-normal plasma glucose profiles were obtained, and urinary sugar and ketone bodies in the blood decreased markedly. The function of the fetoplacental unit also improved. CSII was continued for 58 days to the day of delivery, and she delivered a healthy boy weighing 2, 980 g without complications.<BR>Case 2 was a 51-yr-old female, typical brittle diabetic with frequent attacks of insulin-induced hypoglycemia. During a one-week admission for CSII, she was educated in how to use the portable pump. After her discharge, she regularly measured her blood glucose level with dextrostixr and reported the values to her doctor for medical assessment. She has never experienced hypoglycemic coma, except for a few mild insulin reactions for 6 months at home. Near-normal fasting plasma<BR>glucose and HbAI levels were achieved. During CSII, there were no problems with the batteries, pump or injection sites.<BR>The clinical courses of the two above cases suggest that CSII can be useful for maintaining strict control of blood sugar levels in diabetics, especially in brittle or pregnant diabetics. Although several technical problems remain to be solved, it is concluded from the present observations that long-term CSII is available in its present form.
- 一般社団法人 日本糖尿病学会の論文
一般社団法人 日本糖尿病学会 | 論文
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