Advances in pump technology: insulin patch pumps, combined pumps and glucose sensors, and implanted pumps.

This review discusses the most recent developments in insulin pump technology. The benefits of the insulin pump to patients with type 1 diabetes are recognized both for its metabolic effectiveness and its positive effects on quality of life. The current pumps are reliable, small and light, and are becoming more and more sophisticated.

[Management of gestational diabetes].

Background: Maternal and perinatal complications linked to gestational diabetes could be decreased with an intensive treatment.

Aim: To assess the effect of various treatments, glycaemia targets and procedures for blood glucose self-monitoring, on fetal and maternal prognosis.

Methods: Systematic review of literature studying the efficacy of the treatment of gestational diabetes to decrease fetal morbi-mortality thereof.

Therapeutic management of gestational diabetes.

Background: Maternal and perinatal complications linked to gestational diabetes mellitus could be decreased with an intensive management approach.

Aim: To assess the effect of various treatments, glycaemic targets and procedures for self-monitoring of blood glucose on the foetal and maternal prognosis.

Methods: Systematic review of literature studying the efficacy of the treatment of gestational diabetes in order to decrease maternal-foetal morbidity-mortality.

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.

[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.