Type 1 Diabetes Mellitus ( T1dm ) - 2058 Words

Type 1 diabetes mellitus (T1DM) results from a defect in insulin secretion in the body. T1DM may happen at any age and it is one of the most common chronic diseases of childhood and adolescents (Misso, Egberts, Page, O’Connor, Shaw, 2010). Long-term complications of T1DM include retinopathy, nephropathy, neuropathy, and cardiovascular disease. There is no prevention or cure for T1DM, and the treatment is a life-long insulin replacement regimen. Proper and accurate glycemic control is critical to the management of this disease (Misso et al., 2010, Pankowska, Blazik, Dziechciarz, Szypowska, Szajewska, 2009). â€Å"Optimal metabolic control requires replacement therapy that mimics the insulin profile seen in non-diabetic people as closely as†¦show more content†¦Clinical guidelines are in place for directing treatment of T1DM with either CSII or MDI but there is no clear support for either. This lack of definitive treatment plan prompted the authors of this paper to e xplore this gap in literature. Earlier studies do not show benefits of CSII over MDI primarily because they compared MDI programs to relatively early pumps. These pumps did not afford the advances of technology seen today. Currently there is greater access to cutting-edge technology in the form of smaller, more advanced pumps, hence providing for a more user-friendly experience. There is a scarcity of literature regarding the comparison of newer pumps to MDIs (Fatourechi, et al., 2010). Recent studies were identified and they indicate a preference for CSII therapy. The tools used to measure the effectiveness of therapy were glycosylated hemoglobin (HbA1C), severe hypoglycemic events, daily insulin requirement, and a quality of life survey. According to Misso et al., (2010), â€Å"Both CSII and MDI are forms of intensified insulin treatment, however; due to its continuous basal insulin substitution, CSII can better mimic a physiological situation.† Aim The purpose of this paper is to assess and synthesize recent data to help identify the better treatment therapy between CSII and MDIs. As mentioned earlier there is a lack of support for either regimen from a practitioner standpoint. One could argue that medical practitioners prescribe insulin regimens based on