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1型糖尿病における閉環インスリン投与: 12週間の多センターランダム化試験
Martin Tauschmann1, Hood Thabit2, Lia Bally3
1Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK; Department of Paediatrics, University of Cambridge, Cambridge, UK.
Lancet (London, England)
|October 8, 2018
まとめ
ハイブリッド・クローズド・ループ・インスリン投与は1型糖尿病患者の血糖コントロールを有意に改善した. この高度なシステムは,センサー強化ポンプ療法と比較して,高血糖および低血糖に費やされた時間を短縮しました.
科学分野:
- 内分泌学
- バイオメディカルエンジニアリング
- 臨床研究
背景:
- 1型糖尿病 (T1D) の患者にとって,血糖制御は持続的な課題です.
- 糖尿病の長期的合併症のリスクを高める.
研究 の 目的:
- ハイブリッド・クローズド・ループ (HCL) インスリン投与とセンサ強化ポンプ (SAP) 治療の有効性を評価する.
- T1D患者の血糖制御に対するHCL治療の影響を評価する.
主な方法:
- オープン・マルチセンター・マルチナショナル・パラレル・ランダム・コントロール・試験
- T1DとHbA1cが7. 5~10. 0%であった参加者は,ランダムに12週間にわたってHCLまたはSAP療法を受けた.
- 主要エンドポイント: 12週間の目標グルコース範囲 (3. 9~10. 0 mmol/ L) の時間.
主要な成果:
- HCL治療は,目標グルコースの範囲を大幅に延長した (65%対54%,p< 0. 0001).
- HCL治療は,SAPと比較してHbA1cのより大きな低下をもたらした (差異は0. 36%,p< 0. 0001).
- 低血糖症と高血糖症の期間が短縮され,HCL治療ではインスリン用量や体重に有意な違いは認められなかった.
結論:
- ハイブリッド・クローズド・ループ・インスリン投与はT1Dにおけるグルコースコントロールの改善に効果的です.
- HCL治療は低血糖症のリスクを軽減し,低血糖状態の患者では目標血糖値の範囲の時間を延長します.
- この技術は,様々な年齢層の1型糖尿病の管理に 有望な進歩をもたらします.
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