新诊断为1型糖尿病的儿童最初需要皮下胰岛素
Seyit Ahmet Uçaktürk1, Makbule Çöküş2, Muharrem Bayram2
1Department of Pediatric Endocrinology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey.
Clinical pediatrics
|October 2, 2025
概括
在儿童中新诊断的1型糖尿病 (T1D) 需要更高的初始胰岛素剂量,特别是在糖尿病酸症 (DKA) 中. 胰岛素需要随着时间的推移而减少,但取决于初始呈现的严重程度和体重.
科学领域:
- 儿科 儿科 儿科
- 内分泌学 在内分泌学.
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 1型糖尿病 (T1D) 是一种自身免疫性疾病,需要终身胰岛素治疗.
- 儿童新发型T1D的初始治疗通常涉及住院和仔细的胰岛素剂量定位.
- 了解影响初始胰岛素需求的因素对于有效治疗和患者的治疗结果至关重要.
研究的目的:
- 确定影响T1D新诊断儿童每日皮下胰岛素总剂量 (TDD) 的因素.
- 分析新发型T1D住院期间TDD的变化.
- 为了将最初呈现的严重程度与胰岛素需求相关联.
主要方法:
- 在2020年至2023年期间,85名儿童 (≤18岁) 因新发型T1D而住院后期档案审查.
- 在住院的第一天和最后一天对TDD的分析.
- 跨不同初始呈现群体 (DKA,高血糖症的症) 的TDD比较.
- 多重线性回归分析以确定影响参数.
主要成果:
- 在患有糖尿病酸症 (DKA) 的患者中,初始TDD明显高于患有症和高血糖症的患者 (1.41 ± 0.14 u/kg/day对比1.19 ± 0.18 u/kg/day).
- 从住院的第一天 (1.3 ± 0.16 u/kg/day) 到最后一天 (0.81 ± 0.28 u/kg/day) 的时间,TDD显著下降.
- 入院时的pH值和体重被确定为TDD的显著预测因素.
- 住院最后一天的TDD在所有呈现组中都是相似的.
结论:
- 新诊断T1D的儿童,特别是那些患有DKA的儿童,最初的胰岛素需求很高.
- 在住院期间,胰岛素的需求会减少,但初始酸性疾病的严重程度会影响剂量.
- 皮下胰岛素剂量应根据临床表现个性化,包括酸化症严重程度和体重.
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