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开放循环胰岛素输送系统中的多个基底输注速率:有代谢益处吗?
Juliana Marques Sá1, Sara de Campos Lopes2, Maria Joana Santos1
1Serviço de Endocrinologia do Hospital de Braga, Braga, Portugal.
Archives of endocrinology and metabolism
|February 23, 2024
概括
用于1型糖尿病的连续皮下胰岛素输注 (CSII) 超过四次的每日基数率 (BRs) 不会改善血糖控制. 这种方法增加了低血糖的风险,特别是无症状的低血糖.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 糖尿病管理 糖尿病管理
背景情况:
- 持续的皮下胰岛素输注 (CSII) 是1型糖尿病的关键治疗方法.
- 优化基数率 (BR) 编程对于有效的血糖控制至关重要.
- 在开放循环CSII系统中,每日BR数量对血糖结果和低血糖的影响需要进一步研究.
研究的目的:
- 评估使用开放循环CSII的1型糖尿病患者的每日基数数量 (BR) 和血糖控制之间的关联.
- 确定增加BR数量是否会影响范围内的时间 (TIR),范围以上的时间 (TAR),范围以下的时间 (TBR) 和葡萄糖变化.
- 评估BRs数量与低血糖的发生率之间的关系.
主要方法:
- 一项涉及99名1型糖尿病患者的横截面研究,在开放循环CSII上至少六个月,使用闪光血糖监测.
- 根据每天BR的数量,患者被分为两组:≤4 (G1) 和>4 (G2).
- 组间对血糖控制指标 (HbA1c,TIR,TAR,TBR,GMI,CV) 和低血糖数据进行比较,并对混因子进行回归分析.
主要成果:
- 在≤4 BRs (G1) 和>4 BRs (G2) 的组之间,没有观察到HbA1c,中位糖,GMI,TIR,TAR或葡萄糖变异性的显著差异.
- 使用>4个BRs (G2) 的患者经历了显著增加的低血糖症,无症状的低血糖症和更高的TBR.
- 经过对混因素进行调整后,使用≤4个BRs (G1) 与无症状低血糖的风险较低有关.
结论:
- 编程具有超过四次每日基数率的开放循环CSII设备不会提高1型糖尿病的代谢控制.
- 每日基数率 (>4) 的增加似乎是低血糖症的危险因素,特别是无症状的低血糖症.
- 将基数率编程简化至≤4率,可以在不影响血糖控制的情况下降低低血糖风险.
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