1型糖尿病儿童和青少年的手动闭环胰岛素输送:一个2期随机交叉试验
Roman Hovorka1, Janet M Allen, Daniela Elleri
1Department of Paediatrics, University of Cambridge, Cambridge, UK. rh347@cam.ac.uk
Lancet (London, England)
|February 9, 2010
概括
闭环胰岛素输送系统在1型糖尿病的年轻人中显示出控制一夜间血糖的潜力. 这些系统可以降低夜间低血糖的风险,改善糖尿病管理.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 代谢性疾病研究研究
- 生物医学工程 生物医学工程
背景情况:
- 年轻人1型糖尿病的管理带来了独特的挑战,特别是夜间血糖控制.
- 持续的葡萄糖监测和胰岛素输送系统提供了潜在的解决方案.
- 夜间低血糖是儿童1型糖尿病管理的一个重大风险.
研究的目的:
- 评估闭环胰岛素输送系统在控制1型糖尿病儿童和青少年夜间血糖水平方面的有效性.
- 为了将闭环系统的性能与标准连续皮下胰岛素输液治疗进行比较.
- 评估不同食吸收率和运动对闭环系统性能的影响.
主要方法:
- 三项随机交叉研究涉及19名1型糖尿病患者 (5-18岁).
- 闭环胰岛素输入与标准连续皮下胰岛素输入的比较.
- 在快速和缓慢吸收的食和运动后评估闭环系统的性能.
- 主要结局:时间在目标血糖范围 (3.91-8.00 mmol/L) 内,时间低于3.90 mmol/L.
主要成果:
- 聚合数据分析显示,在闭环递送过程中,在目标葡萄糖范围 (60%对40%,p=0.0022) 内的时间显著增加.
- 闭环系统显著减少了葡萄糖度低于3.90mmol/L (2.1%对4.1%,p=0.0304) 的时间.
- 闭环系统没有记录任何严重的低血糖事件 (<3.0 mmol/L),与标准治疗相比,只有9次.
结论:
- 闭环胰岛素输送系统显示,在患有1型糖尿病的儿科患者中,有潜力改善一夜间血糖控制.
- 这些系统可以显著降低这一群体夜间低血糖症的风险.
- 进一步研究和实施闭环技术可以提高年轻人的糖尿病管理.
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