对1型糖尿病新疗法的益处和风险的看法:一种定性研究
Stephen R Karpen1, Richard Mellor2, Linda A DiMeglio3
1Breakthrough T1D, Washington, District of Columbia, USA. skarpen@breakthrought1d.org.
概括
一型糖尿病患者及其照顾者可以接受疾病修饰和细胞替代治疗等新疗法. 尽管人们对风险感到担忧,但人们高度重视降低胰岛素依赖和胰岛素独立等潜在益处.
科学领域:
- * 内分泌学和代谢疾病研究.
- * 细胞生物学和再生医学
- *以患者为中心的医疗保健和治疗创新.
背景情况:
- * 1型糖尿病 (T1D) 的治疗需要每天大量的精力,并可能导致糖尿病倦怠.
- * 新型治疗方法旨在保留或替换胰腺β细胞,从而提供潜在的疾病修饰或细胞替代.
- 了解患者和护理人员对这些新兴T1D疗法的看法对于开发和实施至关重要.
研究的目的:
- * 探索T1D患者及其护理人员对新型疾病修饰和细胞替代疗法的益处和风险的看法.
- * 收集患者和护理人员考虑和采用这些先进的T1D治疗方法的意愿.
主要方法:
- * 在美国对26名参与者 (T1D的青少年和成年人以及T1D儿童的照顾者) 进行了半结构化的定性访谈.
- * 采用了一种简化讨论方法,介绍新疗法的预先定义的好处和风险.
- 使用定性定向内容分析来解释采访数据.
主要成果:
- * 参与者经常报告糖尿病燃烧和T1D管理对生命的重大影响.
- * 大多数参与者对疾病修饰疗法表示兴趣,优先考虑减少胰岛素依赖和延长缓解期.
- * 考虑细胞替代疗法的意愿很高,原因是胰岛素独立和胰腺功能正常化的前景,尽管注意到对免疫抑制和手术风险的担忧.
结论:
- * 患有T1D的患者及其护理人员对新型治疗策略,包括疾病修饰和细胞替代方案表现出相当的开放性.
- * 主要的感知效益包括减少治疗负担和改善生活质量,而癌症和手术并发症等风险需要仔细考虑.
- 为了成功开发和整合新的T1D疗法, 必须考虑患者和护理人员的观点.
相关概念视频
Diabetes: Management and Pharmacotherapy
354
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...
354
Diabetes Mellitus: Overview and Type I Subtype
3.2K
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...
3.2K
Insulin: Dosing Regimen and Adverse Effects
252
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...
252
Diabetes Mellitus: Type 2 and Gestational
2.9K
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...
2.9K
Oral Hypoglycemic Agents: Biguanides and Glitazones
288
Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
288
Diabetes: Symptoms, Diagnosis, and Complications
684
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
684


