CONOSCERE LE TERAPIE
PER IL DIABETE
LA TERAPIA PIÙ APPROPRIATA
PER OGNI PAZIENTE
Ci sono diversi modi per supportare i pazienti nella gestione dei loro livelli glicemici.
I 6 TRATTAMENTI PER IL DIABETE:
1. Dieta ed esercizio fisico:
È particolarmente utile prescrivere dieta e attività fisica per i pazienti con diabete di tipo 2. L’aiuto di un dietologo e un nutrizionista e l’adozione di uno stile di vita sano possono essere di aiuto ai pazienti per tenere sotto controllo i loro livelli glicemici.
2. Terapia orale:
Se dieta ed esercizio fisico non bastano, possono essere prescritti farmaci orali.
3. Terapia Multi-iniettiva (MDI – Multiple Daily Injection):
Prevede generalmente la somministrazione di almeno quattro iniezioni al giorno.
4. Farmaci insulino-mimetici:
Per i pazienti di tipo 2, è possibile aggiungere alla normale somministrazione di insulina anche farmaci insulino-mimetici (l’ormone incretina), attraverso iniezioni, con l’obiettivo di ridurre i valori di emoglobina glicata ed efficaci in alcuni casi nel controllo del peso.
5. Terapia con microinfusore:
Questa terapia tende a simulare le funzioni di un pancreas sano, per ridurre la necessità di iniezioni frequenti attraverso l’erogazione di specifiche dosi di insulina ad azione rapida.
6. Terapia con sistema integrato:
Il sistema integrato Medtronic si basa su tre componenti fondamentali: un microinfusore di insulina MiniMed, un sistema di monitoraggio continuo del glucosio (CGM) e un software di gestione della terapia
LE SOLUZIONI MEDTRONIC DIABETE NEL PERCORSO TERAPEUTICO DEL PAZIENTE
- IDF Diabetes Atlas, 7th Edit. 2015 Chapter 3 - The Global Picture http://www.diabetesatlas.org/resources/2015-atlas.
html (accessed January 2017) - Guillausseau PJ. Influence of oral antidiabetic drugs compliance on metabolic control in type 2 diabetes: a survey in general practice. Diabetes Metab. 2003;29:79–81
- Luis-Emilio García-Pérez et al. Adherence to Therapies in Patients with Type 2 Diabetes. Diabetes Ther. 2013 Dec; 4(2): 175–194
- Adelphi Market Research 2013. Data on file. All Patients with an HbA1c result PRF. Section C Q3b (n=443)
- McKnight J., et al. Glycaemic control of Type 1 diabetes in clinical practice early in the 21st century: an international comparison. Diabet. Med. 2015;32(8): 1036-1050
- American Association of Diabetes Educators (AADE) Injection Impact Report Survey (n=500) Executive Summary http: //www.injectionimpact.com - (accessed January 2017)
- Kaufman, F.R. et al., A pilot study of the continuous glucose monitoring system: clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects Diabetes Care. 2001 Dec;24(12):2030-4.
- Zhong A. et al, Effectiveness of Automated Insulin Management Features of the Medtronic 640G Sensor-Augmented Insulin Pump. Diabetes Technol Ther. 2016; 18(10): 657-663.
- Joubert M., et al. Diabetes Metab. 2015;41(6)498-508
- Blevins T, Shwartz SL, Bode B et al. A study assessing an injection port foradministration of insulin.Diabetes Spectr. 2008;21(3):197–202
- Riley D, Raup G. Impact of a subcutaneous injection device on improving patient care. Nurs Manage. 2010;41(6):49–50
- van Beers CAJ, et al. Lancet Diabetes Endocrinol. 2016;8587(16):1-10
- Pickup J, Sutton A. Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion. Diabetic Medicine 2008;25:765-774.
- The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.
- The Diabetes Control and Complications Trial/Epidemiology of Diabetes. Interventions and Complications Research Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 2000; 342: 381–389.
- Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, Orchard TJ et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005; 353:2643–2653.
- Aspire: Threshold-Based Insulin-Pump Interruption for Reduction of Hypoglycemia. Bergenstal R.M. et al. N Engl J Med 369:224-32, 2013.
- Ly: Effect of Sensor-Augmented Insulin Pump Therapy and Automated Insulin Suspension vs Standard Insulin Pump Therapy on Hypoglycaemia in Patients With Type 1 Diabetes. A Randomized Clinical Trial. Ly T.T. et al. JAMA 310(12):1240-1247, 2013.
- Standard Italiani per la cura del diabete mellito. SID-AMD. Giugno 2016.
- Vigersky et al., Role of continuous glucose monitoring for type 2 in diabetes management and research- Journal of Diabetes and Its Complications 31 (2017) 280–287
- Sustained efficacy of insulin pump therapy, compared with multiple daily injections, in type 2 diabetes: 12-month data from the OpT2mise randomized trial. Ronnie Aronson, Yves Reznik, Ignacio Conget, Javier A Castañeda, Sarah Runzis, Scott W Lee, and Ohad Cohen for the OpT2mise Study Group. DOI: 10.1111/dom.12642
- Julia Morera et al., Sustained Efficacy of Insulin Pump Therapy in Type 2 Diabetes: 9-Year Follow-up in a Cohort of 161 Patients Diabetes Care 2016;39:e74–e75 | DOI: 10.2337/dc16-0287
- STAR3 - Bergenstal RM et al., Effectiveness of SAP therapy in T1 diabetes, New Engl J Med 2010
- Eurythmics study. 2011 Hermaneides J, Norgaard, Bruttomesso D, SAP Therapy Lowers HbA1C in Sub-Optimally Controlled T1 Diabetes : RCT
- Insulin pump therapy: Best practices in choosing and using infusion devices. 2011. AADE: American Association of Diabetes Educators.
- Centers for Disease Control (CDC). Toxic-shock syndrome in a patient using a continuous subcutaneous insulin infusion pump - Idaho. MMWR. 1983;32(31):404-406, 412.
- Thethi TK, et al. Consequence of delayed pump infusion line change in patients with type 1 diabetes mellitus treated with continuous subcutaneous insulin infusion. J Diabetes Complication. 2010;24(2):73-78.
- Guilherm I, et al. Technical risks with subcutaneous insulin infusion. Diabetes Metab. 2006;32(3):279-284.
- Conwell LS, et al. Dermatological complications of continuous subcutaneous insulin infusion in children and adolescents. J Pediatr. 2008;152(5):622-628.
- Babar GS, et al. Factors associated with adherence to continuous subcutaneous insulin infusion in pediatric diabetes. Diabetes Technol. Ther. 2009;11(3):131-137.
- Schmid et al. Pilot Study for Assessment of Optimal Frequency for Changing Catheters in Insulin Pump Therapy - Trouble Starts on Day 3. J Diabetes Sci Technol 2010;4(4):976-982.
- Data on file - survey conducted in the UK on 43 patients, November 2015.
- Data on file - survey conducted in the NL on 126 patients, November 2014.
Informazioni correlate
TERAPIA MULTI-INIETTIVA (MDI)
È possibile alleviare il dolore e l'ansia associati alla terapia multi-iniettiva.
TERAPIA CON MICROINFUSORE (CSII)
Nuove tecnologie per il paziente e pratiche cliniche.
TERAPIA CON SISTEMA INTEGRATO (SAP)
Con la tecnologia SmartGuard™ in MiniMed 640G, fornisce una protezione avanzata dall’ipoglicemia*
*Choudhary, P. et al. Diabetes Technol. Ther. 2016. Vol 18 (5)