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Research Article
Volume 5 Issue 3 - 2020
Accelerated Intensive Insulin Therapy and its Benefits on Compliance and Glycemic Control
Michael Alexander1, Allison Cimler2, John Elliott2 and Jonathan RT Lakey1,3*
1Department of Surgery, University of California Irvine, Orange, CA, USA
2Alium Health, Scottsdale, AZ, USA
3Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
*Corresponding Author: Jonathan RT Lakey, Professor, Director, Clinical Islet Program, Department of Surgery and Biomedical Engineering, University of California Irvine, Orange, CA, USA.
Received: February 15, 2020; Published: February 27, 2020




Abstract

Background: Intensive insulin therapy (IIT) simulates normal pancreatic function by closely matching the periodicity and amplitude of insulin secretion in healthy non-diabetic subjects. This is achieved by injecting intravenous (IV) insulin in a pulsatile manner and in a pattern matching the observed blood glucose level. This therapy has shown positive beneficial effects on secondary complications of diabetes. However, the duration of each session for this therapy has been associated with lower patient compliance and a high number of hyperglycemic events during insulin therapy.

Objective: We have demonstrated that a shorter IIT protocol duration can improve both patient compliance and reduce the incidence of hyperglycemic events during treatment.

Method: We analyzed the de-identified records of Type 1-2 diabetic patients treated at Diabetic Innovations, LLC. from 2016 - 2019 for reasons related to treatment stopping and discontinuance. A secondary analysis was done on the incidence of hyperglycemic events in patient that underwent both the original IIT protocol and the shortened protocol.

Results: We found that the duration of each treatment (4 hours) in the original protocol is one of the main causes of patients discontinuing their IIT. Analysis of patients who moved from the original to the shorter protocol showed that the shorter protocol with more frequent insulin pulses is associated with reduction in incidence of hyperglycemic events during IIT.

Conclusion: Reducing the length of the IIT protocol into 2 x 1-hour sessions, with 4 minute intervals between insulin pulses, can result in better glycemic control, in addition to potentially improving patient adherence to treatment.

Keywords: Diabetes; Insulin; Infusion; Intravenous Therapy; Hyperglycemic Events

References

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  10. Nakashima Koji., et al. “Practical application of short-term intensive insulin therapy based on the concept of "treat to target" to reduce hypoglycaemia in routine clinical site”. Scientific Reports 10.1 (2020): 1552.
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Citation: Jonathan RT Lakey., et al. “Accelerated Intensive Insulin Therapy and its Benefits on Compliance and Glycemic Control”. EC Endocrinology and Metabolic Research 5.2 (2020): 01-05.

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