medicina49巻5号

2012年05月発行

今月の主題 糖尿病治療薬2012―皆が知りたい新しい治療A to Z 自己注射療法の新たな展開

誰でも始められるインスリンポンプ療法のABC

著者： 内野泰¹ 綿田裕孝¹

所属機関： ¹順天堂大学医学部内科学代謝内分泌学講座

ページ範囲：P.842 - P.845

ポイント

★頻回インスリン注射療法（MDI），インスリンポンプ療法（CSII）のどちらも使用できることは1型糖尿病患者にとって療養の自由度が上がる．

★MDIで管理不十分な1型糖尿病や糖尿病合併妊娠の血糖値管理が可能である．

★ポンプ機器の管理，取扱いは患者自身が行うが，不明な場合は各メーカー24時間コールセンターも利用できる．

★CSII療法の基礎インスリン量は変化するインスリン感受性の日内変動に合わせて設定できる．ベース設定の自由度の高いプレプログラムポンプが主流である．

参考文献

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2）Albers JW, et al:Effect of prior intensive insulin treatment during the Diabetes Control and Complications Trial（DCCT）on peripheral neuropathy in type 1 diabetes during the Epidemiology of Diabetes Interventions and Complications（EDIC）Study. Diabetes Care 33:1090-1096, 2010

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6）Jarosz-Chobot P, et al:Seeking the factors predisposing to local skin inflammatory state development in children with type 1 diabetes（T1DM）treated with continuous subcutaneous insulin infusion（CSII）. Exp Clin Endocrinol Diabetes 115:179-181, 2007

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8）Senstius J, et al:Comparison of in vitro stability for insulin aspart and insulin glulisine during simulated use in insulin pumps. Diabetes Technol Ther 9:517-521, 2007

9）Zisser HC, et al:Siphon effects on continuous subcutaneous insulin infusion pump delivery performance. J Diabetes Sci Technol 4:98-103, 2010

10）Riveline JP, et al:Sexual activity in diabetic patients treated by continuous subcutaneous insulin infusion therapy. Diabetes Metab 36:229-233, 2010

11）Draft Guidance for Industry and Food and Drug Administration Staff:U. S. Department of Health and Human Services Food and Drug Administration Center for Devices and Radiological Health. December 6, 2011