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Biomedical subjects

M F Jannot-Lamotte

Publications and source records attributed to M F Jannot-Lamotte.

3 recordsLinked to original sources
PubMed2005

Factors related to CSII compliance.

Many studies have demonstrated the metabolic efficacy of continuous subcutaneous insulin infusion (CSII) and particularly a reduction of glycaemic fluctuations in type 1 diabetic patients. Despite this benefit, many patients decide to discontinue the use of CSII. To determine the factors related to discontinuation of CSII we analyzed clinical data from a group of 70 patients who had been consecutively started on this treatment from April 2000 to April 2002. Patients were followed for up to 2 years. Eighteen (25.7%) patients decided to terminate CSII during the study after an average of 235 days (range 21-293). The reasons for stopping CSII were decision of the patients (10), end of pregnancy (4), needle site infections (3) and lack of compliance (1). No significant difference was found between patients who had continued and those who had discontinued CSII for age, duration of diabetes, reasons for starting CSII, marital status, prepump concentration of HbA1c and prepump frequency of hypoglycaemia. There tend to be more discontinuations for pregnant women, patients attending hospital visits versus liberal practitioner and patients with lower educational level (below or over baccalaureat) although none of these differences was statistically significant. In conclusion we could not identify any predictive factor of CSII discontinuation.

Adult↗
PubMed2000

[Management of diabetes during corticosteroid therapy].

BACKGROUND: Corticosteroids are generally contraindicated in diabetic patients due to the risk of disrupting glucose control leading to acute decompensation. In some cases however, corticosteroid therapy can be beneficial if given early with a well-controlled regimen. Glucose disequilibrium after withdrawal can be anticipated with proper knowledge of the pharmacokinetics of the glucocorticoid used. FOR PATIENTS WITH TYPE I DIABETES: Ketose acidosis is a real risk in these patients. Insulin dose must be increased and the administration scheme optimized. FOR PATIENTS WITH TYPE II DIABETES: Whether oral drugs should be continued is a question of debate, excepting cases where the underlying disease might cause acute decompensation requiring insulin. Outside this situation, oral drugs can be continued at a higher dose if the fasting serum glucose is below 2 g/L. Finally, it is important to recognized steroid-induced diabetes in order to initiate proper antidiabetic measures. FOR ALL PATIENTS: The glucose curve is reproducible. Basically, the postprandial level rises, warranting repeated insulin injections. Rapid-release analogs and alpha-glucosidase inhibitors appear to be promising; biguanides affect insulin resistance.

Adult↗