A Case of Type 1 Diabetes Treated with Continuous Subcutaneous Insulin Infusion(CSII) for 19 Years

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  • インスリン持続皮下注入療法（ｃｏｎｔｉｎｕｏｕｓ　ｓｕｂｃｕｔａｎｅｏｕｓ　ｉｎｓｕｌｉｎ　ｉｎｆｕｓｉｏｎ：ＣＳＩＩ）により１９年経過した１型糖尿病の１例
  • ショウレイ ホウコク インスリン ジゾク ヒカ チュウシャ リョウホウ(continuous subcutaneous insulin infusion : CSII)ニ ヨリ 19ネン ケイカ シタ 1ガタ トウニョウビョウ ノ 1レイ

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Abstract

We report a case of type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) for 19 years. A 44-year-old female developed type 1 diabetes when she was 24 years old and was treated with Lente insulin for one year. As a result of poor glycemic control, she was switched to CSII and her glycemic control subsequently stabilized. She was hospitalized due to a hypoglycemic coma at an age of 29 years and due to diabetic ketoacidosis at an age of 38 years. During the 19 years of CSII, her mean HbA1c, systolic blood pressure, and diastolic blood pressure were 7.8%, 112mmHg, and 67mmHg, respectively. At present, her optic fundi are normal and her urine albumin excretion rate is 4.7mg/g·Cr. Nerve conduction velocity studies showed a decrease in sensory nerve action potential in the median and sural nerves, indicating the presence of early diabetic polyneuropathy. A carotid ultrasonography showed no increase in the intima-media thickness. An echocardiography revealed a mild diastolic dysfunction of the left ventricle. Pulse wave velocity measurements showed a slight increase in the brachial-ankle pulse wave velocity. We believe that the present case illustrates the effectiveness of CSII as a therapeutic option for type 1 diabetes.

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