| 1. |
- Lindholm Olinder, Anna, 1960-, et al.
(författare)
-
Continuous subcutaneous insulin infusion in young girls : a two-year follow-up study
- 2007
-
Ingår i: European Diabetes Nursing. - : John Wiley & Sons. - 1551-7853 .- 1551-7861. ; 4:1, s. 34-39
-
Tidskriftsartikel (refereegranskat)abstract
- Aims:To investigate why young girls decided to start continuous subcutaneousinsulin infusion (CSII) therapy, and to examine their opinions and concerns withregard to using an insulin pump. In addition, the girls were evaluated for HbA1cvalues, insulin requirements and body mass index standard deviation score (BMISDS) over a period of two years after starting CSII compared with a group of girlsusing multiple daily injections (MDI).Methods:Twelve girls (mean age 10.8 years) starting CSII were followed over a period of two years. Why the girls started CSII and whether they preferred CSII orMDI were investigated. Their statements about CSII were analysed and categorisedby two paediatric diabetes nurses. On four occasions HbA1c values, insulin require-ment and BMI SDS were collected and compared with those of a control group of 12 girls using MDI for the same period of time.Results:The girls started CSII due to a desire to test pump therapy, and their experiences of unstable blood glucose. They preferred CSII to MDI. The main positive statements were categorised as ‘quality-of-life benefits’. The main negativecategory was ‘the pump gets in the way’. In the CSII group, HbA1c decreased from8.5 (7.4–9.5) to 7.5 (6.9–8.1) (p<0.05) over two years, and the insulin requirementdecreased by 30%. In the control group these values were unchanged. There wereno changes in the BMI SDS mean values for either group.Conclusion:CSII was well accepted by the young girls, facilitated a decrease inHbA1c values, and did not result in weight gain.
|
|
| 2. |
- Lindholm Olinder, Anna, 1960-, et al.
(författare)
-
Post-prandial glucose levels following three methods of insulin bolusing : A study in adolescent girls and in comparison with girls without diabetes
- 2009
-
Ingår i: Practical diabetes international. - : Wiley. - 1357-8170. ; 26:3, s. 110-115
-
Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to assess whether one method of insulin bolusing wassuperior to two others in managing two pasta meals, and to compare the glucose levelswith those of females without diabetes.Fifteen continuous subcutaneous insulin infusion (CSII)-treated adolescent femalesand 10 adolescent females without diabetes consumed two pasta meals with different fatcontents. The plasma glucose (p-glucose) values were followed using capillarymeasurement and continuous glucose monitoring (CGMS) until three hours after themeal. The CSII-treated females received the same insulin dose at every occasion as:(1) normal bolus; (2) dual-wave bolus – 60% of the dose as normal bolus and 40% overone hour; and (3) square-wave bolus – a prolonged dose over one hour.No differences were found in p-glucose peak or AUC between the bolus methodsafter either of the meals. There was a difference in p-glucose increase at one time pointafter the less fat meal; after 60 minutes the increase was greater with a square-wavebolus (Friedman’s test p<0.02). Forty-eight percent of the measurements among thediabetes adolescents showed post-prandial p-glucose levels ≤10mmol/L. Femaleswithout diabetes had earlier and lower p-glucose peak and smaller AUC.It was concluded that there were no overall differences in p-glucose excursionsbetween different methods of bolusing for these adolescent females after these meals. Asquare-wave bolus may be less favourable with a less fatty pasta meal, giving a higherp-glucose increase. It was possible to achieve normoglycaemic post-prandial p-glucoselevels among adolescents with diabetes.
|
|
| 3. |
- Lindholm Olinder, Anna, 1960-, et al.
(författare)
-
Treatment with CSII in two infants with neonatal diabetes mellitus
- 2006
-
Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 7:5, s. 284-288
-
Tidskriftsartikel (refereegranskat)abstract
- This article reports the case studies of two children with neonatal onset of diabetes who were treated with continuous subcutaneous insulin infusion (CSII) from within 4 d to 3 wk of the diagnosis. The aim was to describe diabetes-related and insulin-pump-specific data in relation to growth and various feeding patterns when using CSII in infants with diabetes during their first year of life. The two children's medical records were scrutinized. The results showed that both children had good metabolic control [median hemoglobin A1c (HbA1c) 5.3 and 5.7%, high performance liquid chromatography (HPLC) method, reference: 3.4-5.0%. Compared with the Diabetes Control and Complications Trial (DCCT) HbA1c units, Swedish units give approximately 1% point lower results]. No episodes of severe hypoglycemia or diabetic ketoacidosis have been demonstrated. The children had normal growth patterns, as they followed a normal feeding regime for their age. The meal doses of insulin were given over 12 min to 3 h. The children had diluted Humalog((R)) insulin 10 U/mL (Eli Lilly & Co, Indianapolis, IN, USA) in their pumps. Different types of insulin pumps were used, namely, the Minimed 507C and 508 (Medtronic, Minneapolis, MN, USA), and a Disetronic H-tron V100 (Roche Diagnostics, Basel, Switzerland). The children used different types of infusion sets. Neither family reported any technical problems with their pump system. CSII was an effective and safe treatment for the two children suffering from neonatal diabetes. This offers an alternative for other infants with a similar diagnosis.
|
|
| 4. |
- Olinder, Anna Lindholm, 1960-, et al.
(författare)
-
Missed bolus doses : devastating for metabolic control in CSII-treated adolescents with type 1 diabetes
- 2009
-
Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 10:2, s. 142-148
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the management of continuous subcutaneous insulin infusion (CSII) in adolescents with type 1 diabetes including their administration of bolus doses and to study relationships between insulin omission and metabolic control, body mass index, daily frequency of self-monitoring of blood glucose (SMBG) and bolus doses, health-related quality of life (HRQOL), the burden of diabetes and treatment satisfaction. METHODS: Ninety CSII-treated (> or =6 months) adolescents aged 12-18 yr, from four diabetes clinics in Sweden, participated in the study. The adolescents recorded their meal intake the previous day, which was compared with downloaded pump data, and the frequency of missed boluses was stated. Haemoglobin A1c (HbA1c) and diabetes-related data were recorded. HRQOL and treatment satisfaction were measured with questionnaires. RESULTS: Thirty-eight per cent of the adolescents had missed >15% of the doses the previous day, those had higher HbA1c (7.8 +/- 1.0 vs. 7.0 +/- 1.2%, p = 0.001), took fewer daily boluses (3.8 +/- 1.7 vs. 5.3 +/- 1.7, p < 0.001) and SMBG (2.4 +/- 1.8 vs. 3.6 +/- 1.8, p = 0.003), were less satisfied with their treatment (4.8 vs. 5.3, scale 0-6, p = 0.029) and perceived the medical treatment more negatively (72.1 vs. 79.7, scale 0-100, p = 0.029). Multiple linear regression analysis showed that the variations in HbA1c could be explained by the frequency of bolus doses (p = 0.013) and SMBG per day (p < 0.0001) adjusted for duration and age (r(2) = 0.339, p < 0.0001). CONCLUSION: Insulin omission was common. Those who missed doses were less satisfied and perceived more impact with the treatment. The frequencies of daily boluses and SMBG were associated with metabolic control. Diabetes teams need strategies to guide adolescents on how to avoid insulin omission.
|
|
| 5. |
- Lindholm Olinder, Anna
(författare)
-
Self monitoring of blood glucose in CSII-treated adolescents with type 1 diabetes
- 2008
-
Ingår i: Self monitoring of blood glucose in CSII-treated adolescents with type 1 diabetes.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Many diabetic clinics in Sweden recommend four self monitoring of blood glucose (SMBG) per day for CSII treated adolescents, however it is common that CSII treated adolescents with type 1 diabetes perform fewer SMBG than recommended.Objectives: To compare age, diabetes duration, HbA1c value, frequency of daily bolus doses and health related quality of life (HRQOL) measured with the “Disabkids” questionnaire, between CSII treated adolescents who perform less than four SMBG per day and CSII treated adolescents who perform four or more.Methods: Data were obtained from 91 CSII treated adolescents (aged 12-18), who were regularly attending four different paediatric diabetes clinics in Sweden, all recommending four SMBG per day. Unpaired t-test was used to compare the group who took < 4 SMBG/day with the group who took > 4 SMBG/day. Nominal logistic regression analysis was used to compare the two groups.Results: The mean frequency of SMBG/day was 3.2. Forty-four % (40/91) of the adolescents performed four or more SMBG/day. The adolescents who performed the recommended frequency of SMBG were younger, had shorter diabetes duration, had lower HbA1c, took more daily bolus doses and perceived less impact of the medical treatment. There were no differences in general HRQOL between the two groups. Nominal logistic regression analysis showed that of these factors only HbA1c was independently associated to > 4 SMBG/day (p<0.001).Conclusion: Fifty-sex % of the adolescents performed fewer SMBG than recommended. The frequency of SMBG was associated with the metabolic control. The diabetes teams need new strategies to motivate adolescents to perform more SMBG.
|
|
