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2型糖尿病成年人的设备支持的自动基础胰岛素定位:随机对照试验的系统审查和元分析
Yingying Luo1, Yaping Chang2, Zhan Zhao3
1Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing 100044, China.
The Lancet regional health. Western Pacific
|July 10, 2023
概括
自动基础胰岛素定位有助于通过改善HbA1c水平来管理2型糖尿病. 这项技术在不增加低血糖风险的情况下显示出好处,因此需要进一步调查患者因素和成本效益.
科学领域:
- 内分泌学 在内分泌学.
- 糖尿病管理 糖尿病管理
- 医疗卫生技术 技术 技术
背景情况:
- 技术进步使得在2型糖尿病中基础胰岛素 (BI) 剂量定位的自动化算法成为可能.
- 设备支持系统为糖尿病护理提供了潜在的改进.
研究的目的:
- 与传统护理相比,评估与自动化BI定位相关的疗效,安全性和生活质量.
- 综合自动化胰岛素剂量随机对照试验的证据.
主要方法:
- 进行了随机对照试验的系统审查和元分析.
- 搜索涵盖了2000年1月至2022年2月的主要数据库 (Medline,Embase,Web of Science,Cochrane).
- 随机效应元分析计算了风险比率和平均差异,用GRADE评估证据确定性.
主要成果:
- 包括六项研究 (889名患者). 自动化BI定位显示,达到HbA1c<7.0% (RR 1.82) 的可能性更高,HbA1c水平更低 (MD -0.25%).
- 在禁食葡萄糖,低血糖发病率 (严重或夜间) 或生活质量方面没有发现显著差异.
- 大多数结果的证据确定性从低到非常低不等.
结论:
- 自动基础胰岛素定位在降低HbA1c的过程中提供了适度的好处,而不会增加低血糖的风险.
- 建议进行进一步的研究,以探索患者的态度和自动胰岛素定位的成本效益.
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