Beyond the barriers of the use of continuous subcutaneous insulin therapy in type 1 diabetes: a new opportunity from catheter-less insulin pumps

Authors

  • Katherine Esposito Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Napoli and Unit of Diabetes, University of Campania “Luigi Vanvitelli”, Napoli - Italy
  • Andrea Mario Bolla Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milano - Italy
  • Francesco Costantino Section of Diabetology, Department of Pediatrics, Sapienza University, Roma - Italy
  • Maurizio Delvecchio Metabolic Diseases, Clinical Genetics and Diabetology Unit, Policlinico “Giovanni XXIII”, Bari - Italy
  • Chiara Molinari Department of Internal Medicine and San Raffaele Diabetes Research Institute, IRCCS San Raffaele Hospital, Milano - Italy
  • Carlo Negri Unit of Endocrinology and Metabolism – Azienda Ospedaliera Universitaria Integrata di Verona, Department of Medicine, University of Verona, Verona - Italy
  • Michela Petrizzo Unit of Diabetes, University of Campania “Luigi Vanvitelli”, Napoli - Italy
  • Emanuele Bosi Department of Internal Medicine and San Raffaele Diabetes Research Institute, IRCCS San Raffaele Hospital, Milano - Italy

DOI:

https://doi.org/10.33393/ao.2021.2266

Keywords:

CSII, Glycemic control, Hypoglycemia/prevention and control, Insulin/administration and dosage, Subcutaneous infusion, Type 1 diabetes mellitus

Abstract

Although it represents a valid alternative for patients with type 1 diabetes (T1DM) with insufficient glycemic control and/or with recurrent hypoglycemia, insulin pump therapy (Continuous Subcutaneous Insulin Infusion, CSII) in Italy is nowadays still relatively uncommon. The following review aims to investigate the barriers that limit the transition to CSII and the reasons behind the widespread cases of drop-out, particularly evident in younger patients. Among the interventions that could contribute to the solution of the problem, catheter-less insulin pumps (or patch-pumps) will be described: a tool potentially able to reduce, if not eliminate, some of the main obstacles encountered by patients. In particular, a new opportunity has become available today thanks to the evolution of the generation of catheter-less insulin pumps represented by Accu-Chek® Solo (Roche Diabetes Care GmbH), therefore three clinical cases of patients with T1DM undergoing therapy with the Accu-Chek® Solo insulin pump will be presented and discussed herein.

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