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Abb. 3: Links: Fehlerhaftes Unterbrechen der Insulinzufuhr durch den LGS-Algorithmus: Aufgrund eines niedrigen ISIG (Input-Signal am Glukosesensor) bei mangelndem Substratfluss um die Sensorelektrode werden die Glukosewerte als niedrig fehlinterpretiert und die Insulinabgabe wird unterbrochen. Rechts: Tabellarische Darstellung der ISIG-Werte (rechte Spalte) in Korrelation zu den Glukosewerten (retrospektive Analyse aus dem Programm CareLink™).
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Abstract
The connection of insulin pumps with continuous glucose monitoring system (CGM) transforms the insulin pump therapy (CSII) to sensor- augmented pump therapy (SAP).
The fully automated control of insulin therapy by computer algorithms based on sensor data seems to come closer, however, market-ready models are not yet available. Currently, t...
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Citations
... If the calculation results are predicted to be in the safe range above this limit again, the insulin infusion is resumed. 19 This form of therapy requires trust in the system, 20 since use is associated with a transfer of tasks and responsibility to the device's algorithm. Since the patients and their parents have to modify their attitudes regarding 'treatment of hypoglycaemia' established by conventional education, a good, detailed and repetitive structured training of the patients, for example, according to the training programme SPECTRUM, 21 is necessary. ...
For paediatric patients with type 1 diabetes, intensified insulin therapy with either multiple daily injection or insulin pump therapy is currently the only method of treatment. To optimize this therapy, insulin analogues are fixed parts of all therapy regimens. New ultra-rapid insulins seem to be beneficial not only in adults but also in this age group. New developments in long-acting analogues have demonstrated safety and will be regular in paediatrics, we hope, soon. Furthermore, the psychosocial approach for consideration of real-life aspects becomes more the focus of therapeutic regimens and is implemented into international guidelines. Technical improvements, such as continuous glucose monitoring, particularly in combination with pump therapy, support the great success of rapid-acting analogues by reducing hypoglycaemias. Non-insulin agents such as SGLT2-inhibitors show beneficial aspects in people with type 1 diabetes. For outpatient care with these currently off-label-used drugs, special training for measurement of ketones should be imperative.
