混合闭环 (HCL) 胰岛素输送系统的积极预期差异不能解释HCL使用的种族差异
Jody B Grundman1, Amanda Perkins1, Maureen Monaghan1,2
1Children's National Hospital, 111 Michigan Ave NW, Washington DC 20010, USA.
Journal of clinical & translational endocrinology
|June 5, 2023
概括
混合闭环 (HCL) 系统在1型糖尿病 (T1D) 管理方面表现有前途. 这项研究发现,对HCL技术的积极期望在边缘化青年和对照组之间没有差异,这表明其他因素影响HCL使用不平等.
科学领域:
- 内分泌学 在内分泌学.
- 糖尿病 技术 技术
- 健康 公平 卫生 公平
背景情况:
- 混合闭环 (HCL) 胰岛素输送系统为患有1型糖尿病 (T1D) 的年轻人提供了改善的血糖控制和生活质量.
- 现有研究表明,不同患者群体在采用和使用HCL系统方面存在差异.
- 了解导致这些不平等的因素对于促进平等获得先进的糖尿病技术至关重要.
研究的目的:
- 调查HCL系统的积极预期差异是否有助于在T1D的年轻人中观察到它们的使用不平等.
- 来自一个关键试验的公共保险,非西班牙裔黑人 (NHB) 青年和主要非西班牙裔白人,私人保险队伍之间对HCL技术的看法和期望进行比较.
主要方法:
- 一项涉及15名患有T1D和低于最佳血糖控制 (HbA1c ≥10%) 的NHB年轻人的研究,使用Tandem t:slim X2胰岛素与Control-IQ技术连续6个月.
- 基线评估包括患者报告的结果 (PROs),使用INSPIRE调查对积极的HCL预期和PAID调查对与糖尿病相关的痛苦.
- 基线特征,血糖指标,INSPIRE和PAID得分与Tandem Control-IQ儿科关键试验 (DCLP5) 的数据进行比较.
主要成果:
- 与DCLP5队列 (HbA1c 7.6% ± 0.9%) 相比,研究队列在基线时具有显著较差的血糖控制 (HbA1c 11.9% ± 1.4%) .
- 尽管血糖控制较差,父母与糖尿病相关的痛苦较高,但研究队列中的年轻人和父母都报告了与DCLP5队列一样高的HCL系统的积极预期分数.
- 与DCLP5队列相比,研究队列中的年轻人没有显著增加与糖尿病相关的痛苦.
结论:
- 对混合闭环系统的积极预期在历史上被边缘化的患有T1D的青年和主要非西班牙裔白人,私人保险队伍之间是可比的.
- 对HCL技术的感知好处或预期的差异似乎不是系统使用不平等的主要驱动因素.
- 需要进一步的研究来识别和解决导致HCL系统采用和利用差异的潜在因素.
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