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在非最佳控制的1型糖尿病中提供闭环胰岛素:多中心,12周随机试验
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
概括
在1型糖尿病患者中,混合闭环胰岛素可显著改善血糖控制. 与传感器增强治疗相比,这种先进的系统减少了高血糖和低血糖的时间.
科学领域:
- 内分泌学
- 生物医学工程
- 临床研究
背景情况:
- 对于1型糖尿病 (T1D) 患者来说,血糖控制是一个持续的挑战.
- 低于最佳的血糖控制增加了长期糖尿病并发症的风险.
研究的目的:
- 评估混合闭环 (HCL) 胰岛素输送与传感器增强 (SAP) 治疗的有效性.
- 评估HCL治疗对T1D患者血糖控制的影响.
主要方法:
- 一个开放的,多中心的,多国性的,并行的随机对照试验.
- 具有T1D和HbA1c7. 5 - 10. 0%的参与者被随机分配到HCL或SAP治疗12周.
- 主要终点:在12周内达到目标血糖范围 (3. 9 - 10. 0 mmol/ L) 的时间.
主要成果:
- HCL治疗显著增加了目标血糖范围的时间 (65%与54%,p< 0. 0001).
- 与SAP相比,HCL治疗导致HbA1c的降低较大 (0. 36%的差异,p< 0. 0001).
- 在HCL治疗中观察到低血糖和高血糖的时间减少;胰岛素剂量或体重没有显著差异.
结论:
- 混合闭环胰岛素有效改善T1D的葡萄糖控制.
- HCL治疗降低了低血糖风险,并提高了目标血糖范围的时间.
- 这项技术为各种年龄组的1型糖尿病治疗提供了有前途的进展.
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