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Exp Clin Endocrinol Diabetes 1987; 90(4): 51-61
DOI: 10.1055/s-0029-1210672
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© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

36 Months Continuous Subcutaneous Insulin Infusion (CSII) in Insulin Dependent Diabetes (IDDM) - Influence on Early Stages of Retinopathy, Nephropathy and Neuropathy - Psychological Analysis6)8)

H. Bibergeil1 , Irmtraud Hüttl1 , W. Felsing1 , Ute Felsing1 , Ingetraut Seidlein2 , Sabine Herfurth2 , J. Dabels4 , G. Reichel3 , Christiane Lüder1 , G. Albrecht1 , W. Bruns5 , Ruth Menzel1
  • 1Central Institute of Diabetes “Gerhardt Katsch” Karlsburg/GDR (Director: OMR Prof. Dr. sc. med. H. Bibergeil)
  • 2Clinic of Ophthalmology (Director: OMR Prof. Dr. sc. med. G. Franke)
  • 3Clinic of Neurology and Psychiatry (Director: OMR Prof. Dr. sc. med. G. Rabending) of the Ernst Moritz Arndt University Greifswald/ GDR
  • 4Clinic of Internal Medicine of the Wilhelm Pieck University Rostock/GDR (Director: OMR Prof. Dr. sc. med. H. Klinkmann)
  • 5Clinic-Sanatorium for Diabetes “Bergfried” Saalfeld/GDR (Director: MR Prof. Dr. sc. med. W. Bruns)
6) This study is part of research project HFR 22 of the Ministry of Health of the GDR. 8) This paper is a tribute to the late Professor Gerhardt Katsch, who would have celebrated his 100thbirthday in 1987.
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Publication History

1986

Publication Date:
16 July 2009 (online)

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Summary

In extremely unstable (brittle) IDDM patients (n = 11) the metabolic effect of long-term (36 months) CSII proved to be superior to conventional insulin treatment (CIT) (statistical twins, n = 11): HbA1 = 8.6 ± 0.3 versus 10.4 ± 0.4, MBG = 5.6 ± 0.3 versus 8.5 ± 0.8, M (80)-value = 23.6 ± 0.6 versus 56.7 ± 10.2, GCI[7)] = 37.3 ± 15.6 versus 132 ± 24.2. In addition, in CSII patients the metabolic control was significantly better than intensified conventional insulin treatment (ICT) before. Retinal morphology improved under CSII in 1 eye, did not change in 10 eyes and deteriorated in 11 eyes. Under CIT retinal findings improved in none, did not change in 16 and deteriorated in 16 eyes. Deteriorations under CSII appeared more frequently during the first than during the second and third year of treatment and seemed to be a consequence of too strict metabolic control and/or too fast decrease of the glycemia at the beginning of CSII. During 36 months of CSII no deterioration but in one case normalization of microproteinuria was observed. Under CIT three cases changed from normal into microproteinuria. Reduced motor nerve conduction velocity (MCV) and/or sensory nerve conduction velocity (SCV) could be normalized in most cases under CSII, but respiratory heart arrhythmia (RHA) at rest could not. Most patients — if highly motivated before starting CSII — remained positively motivated for long-term pump therapy. In conclusion : Our experiences over three years demonstrate a positive effect of CSII on the metabolism as well as on the course of early stages of microangiopathy and neuropathy. A longer period of observations will be necessary to evaluate this, conclusively.

Key words

Continuous subcutaneous insulin infusion (CSII) - Retinopathy - Nephropathy - Neuropathy - Psychological analysis

1 Glycemia Control Index (= MBG + œ Ampl.).

1 Glycemia Control Index (= MBG + œ Ampl.).