一个随机试验的闭环胰岛素递送产后在1型糖尿病
Lois E Donovan1, Denice S Feig2, Patricia Lemieux3
1Departments of Medicine and Obstetrics and Gynecology, Cumming School of Medicine, University of Calgary and Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
Diabetes care
|October 12, 2023
概括
患有1型糖尿病的产后患者使用闭环胰岛素输送经历了较少的低血糖. 这种混合闭环系统证明了在分娩后控制血糖水平的安全性和有效性.
科学领域:
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
- 生殖健康 生殖健康
背景情况:
- 第1型糖尿病的产后管理带来了独特的血糖挑战.
- 保持最佳的血糖控制对于母亲和婴儿的健康至关重要.
- 关于产后期先进的胰岛素输送系统的数据有限.
研究的目的:
- 评估产后期混合闭环胰岛素输送的疗效和安全性.
- 为了比较闭环系统的性能与传感器增强疗法.
- 评估对血糖控制和低血糖率的影响.
主要方法:
- 进行了一项开放标签,随机对照试验.
- 患有1型糖尿病的参与者被随机分配到混合闭环 (MiniMed 670G/770G自动模式) 或传感器增强疗法,持续12周.
- 所有参与者都过渡到闭环治疗,随后进行12周的延续阶段.
主要成果:
- 在随机阶段,两组之间的时间范围 (70-180 mg/dL) 没有显著差异.
- 闭环胰岛素输送显著减少了低于70 mg/dL和54 mg/dL (低血糖症) 的时间.
- 在这两组中都没有报告糖尿病酸症或严重低血糖症.
结论:
- 混合闭环胰岛素输送是产后安全有效的.
- 这项技术显示出在患有1型糖尿病的产后个体中降低低血糖的潜力.
- 这些发现支持使用闭环系统来改善产后血糖管理.
相关概念视频
Insulin: Dosing Regimen and Adverse Effects
185
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
185
Pathophysiology of Diabetes
956
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
956
Diabetes Mellitus: Type 2 and Gestational
2.5K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.5K
Insulin Formulations: Types and Delivery
205
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
205
Diabetes Mellitus: Overview and Type I Subtype
2.7K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.7K
Diabetes: Management and Pharmacotherapy
290
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
290


