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1型糖尿病成年人反弹高血糖的频率 治疗不同胰岛素输送方式的1型糖尿病成年人
Katrine Grønbæk Tidemand1, Christian Laugesen1, Ajenthen Gayathri Ranjan1
1Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark.
Diabetes technology & therapeutics
|July 25, 2024
概括
患有1型糖尿病 (T1D) 的人通常在低血糖症后与反弹性高血糖症 (RH) 斗争. 像自动胰岛素输送 (AID) 这样的先进技术在减少RH严重程度和持续时间方面表现有前途,改善整体血糖控制.
科学领域:
- 内分泌学 在内分泌学.
- 代谢疾病 代谢疾病
- 糖尿病 技术 技术
背景情况:
- 管理1型糖尿病 (T1D) 涉及平衡低血糖治疗与避免反弹高血糖 (RH).
- 在T1D患者中,RH对实现最佳血糖控制构成挑战.
- 不同的糖尿病管理技术可能会影响RH频率和严重程度.
研究的目的:
- 调查各种T1D治疗方式中RH的发生率和严重程度.
- 评估RH对血糖控制的影响,特别是目标范围内的时间 (TIR).
- 为了比较每日多次注射 (MDIs),胰岛素,传感器增强 (SAPs) 和自动化胰岛素输送 (AID) 系统之间的RH结果.
主要方法:
- 一个成年T1D患者的横截面,现实世界的研究,使用持续的葡萄糖监测.
- RH定义为传感器葡萄糖>10.0 mmol/L 在传感器葡萄糖<3.9 mmol/L的2小时内.
- 根据曲线下的面积 (AUC) 评估RH的严重程度;在MDI,非集成,SAP和AID用户之间进行比较.
主要成果:
- 传感器增强 (SAP) 和AID用户表现出最高的RH发病率 (约. 2个事件/周).
- 在SAP和AID组中,大约40%的低血糖事件导致RH.
- 与MDI用户 (185分钟) 相比,AID用户的RH持续时间 (122分钟) 显著缩短.
- RH严重程度与先进技术使用相反,与TIR积极相关.
结论:
- 虽然先进系统中的胰岛素悬浮特征与较高的RH频率相关,但AID系统似乎可以减轻RH的严重程度和持续时间.
- 低血糖严重程度与TIR之间的反向关系强调了在低血糖管理策略中考虑RH的重要性.
- 为改善T1D管理,进一步研究优化AID算法以最大限度地减少RH是有必要的.
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