Guilhem I, Leguerrier A M, Lecordier F, Poirier J Y, Maugendre D
Unité de Diabétologie, CHU de Rennes, France.
Diabetes Metab. 2006 Jun;32(3):279-84. doi: 10.1016/s1262-3636(07)70281-1.
The popularity of continuous subcutaneous insulin infusion (CSII), as a way for achieving long term strict glycaemic control in diabetic patients, has increased over the last ten years. Most reports on technical faults, often leading to metabolic emergencies, mainly ketoacidosis, have been published in the 1980s. Obstruction of infusion set and infection of infusion site are the most frequent events. Insulin precipitation or aggregation is thought to be one of the precipitating factors. Few data are available about failures of the pump itself. We report our experience of pump malfunctions recorded between 2001 and 2004 in 376 pumps used by patients treated with CSII therapy in Brittany. Recent studies indicate a decrease of metabolic complication frequency during CSII. This suggests technical improvements and/or a greater experience of physicians in selecting and educating patients. We report instructions for monitoring insulin pump therapy that should be included in a formal educational program for pump users. Clinical studies using newly available devices should reassess technical risks associated with CSII.
作为糖尿病患者实现长期严格血糖控制的一种方式，持续皮下胰岛素输注（CSII）在过去十年中越来越受欢迎。关于技术故障（常导致代谢急症，主要是酮症酸中毒）的大多数报告发表于20世纪80年代。输注装置堵塞和输注部位感染是最常见的事件。胰岛素沉淀或聚集被认为是促发因素之一。关于泵本身故障的数据很少。我们报告了2001年至2004年间在布列塔尼接受CSII治疗的患者使用的376台泵中记录的泵故障情况。最近的研究表明CSII期间代谢并发症的发生率有所下降。这表明技术有所改进和/或医生在选择和教育患者方面更有经验。我们报告了胰岛素泵治疗监测的指导原则，这些原则应纳入针对泵使用者的正式教育计划中。使用新设备的临床研究应重新评估与CSII相关的技术风险。
