- Title
- Reducing acute hyperglycaemia in insulin pump therapy
- Creator
- Lopez, Prudence Elizabeth
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2018
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- This thesis describes potential causes of acute hyperglycaemia in insulin pump therapy. Included in the thesis are four articles published in scientific literature aimed at reducing acute hyperglycaemia in insulin pump therapy. The first article reviews causes of bubble formation in insulin pump cartridges and lines. Pressure and temperature changes were identified as potential causes of bubble formation. Article two describes the use of extended insulin boluses for standard meals. The extended bolus was not able to control postprandial glycaemia as well as a standard bolus and therefore has limited clinical utility. The third article compares five different combination bolus splits to a standard bolus for a high fat and protein meal. Combination bolus was able to control the immediate postprandial glucose spike as well as standard bolus when at least 50% of the total insulin dose was given in the standard bolus component of the combination bolus. Furthermore, when at least 70% of the combination bolus was given as an extended bolus the glucose control was improved in the late postprandial period. This study suggests that combination bolus may be superior to standard bolus for a high fat and protein meal, however additional insulin may be required. The final study compared carbohydrate quantification with carbohydrate, fat and protein counting (Pankowska Equation) and food insulin index for a high fat and protein meal. Whilst Pankowska Equation reduced postprandial hyperglycaemia this was at the cost of a significant increase in hypoglycaemia.
- Subject
- type 1 diabetes; insulin pump therapy
- Identifier
- http://hdl.handle.net/1959.13/1393826
- Identifier
- uon:33614
- Rights
- Copyright 2018 Prudence Elizabeth Lopez
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 1 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 192 KB | Adobe Acrobat PDF | View Details Download |