Bruttomesso D, Pianta A, Crazzolara D, Scaldaferri E, Lora L, Guarneri G, Mongillo A, Gennaro R, Miola M, Moretti M, Confortin L, Beltramello G P, Pais M, Baritussio A, Casiglia E, Tiengo A
Department of Clinical and Experimental Medicine, Cattedra di Malattie del Metabolismo, University of Padua, Via Giustiniani 2, 35128 Padua, Italy.
Diabet Med. 2002 Aug;19(8):628-34. doi: 10.1046/j.1464-5491.2002.00750.x.
To study the effect of continuous subcutaneous insulin infusion (CSII) on metabolic control and well-being in patients with Type 1 diabetes.
Efficacy, safety and interference with everyday life associated with CSII were studied retrospectively in 138 diabetic patients from the Veneto region treated for 7.4 +/- 0.4 years.
Glycosylated haemoglobin decreased during the first year of CSII from 9.3 +/- 0.2% to 7.9 +/- 0.1% (P < 0.0001), and then remained unchanged. Serious hypoglycaemia decreased from 0.31 +/- 0.07/year to 0.09 +/- 0.02/year (P < 0.003), as did ketoacidosis (from 0.41 +/- 0.12/year to 0.11 +/- 0.03/year, P < 0.013). During the first year of therapy daily insulin requirement decreased from 49 +/- 1 to 42 +/- 2 U/day (P < 0.0001) and did not change thereafter. The number of out-patient consultations and hospital admissions per year also decreased significantly. CSII was associated with a progressive increase of body weight (P < 0.05) and with 0.2 +/- 0.04 infections/patient per year at the infusion site. Infection was rated as mild in 72%, moderate in 18%, severe in 10%. Patients reported that CSII improved metabolic control (71%), sense of well-being (41%), and allowed more freedom (40%). Quality of life, assessed using the DQOL, after 7 years of CSII was rated as good by patients (score of 73.0 +/- 1.8 on a scale from 0 to 100).
This retrospective analysis suggests that CSII improves metabolic control in Type 1 diabetic patients, reduces hypoglycaemic and ketoacidotic events, is well accepted, allows a good quality of life and decreases out-patient consultations and hospital admissions.
研究持续皮下胰岛素输注（CSII）对1型糖尿病患者代谢控制及健康状况的影响。
对来自威尼托地区的138例糖尿病患者进行回顾性研究，这些患者接受CSII治疗7.4±0.4年，研究CSII的疗效、安全性及对日常生活的干扰情况。
在CSII治疗的第一年，糖化血红蛋白从9.3±0.2%降至7.9±0.1%（P<0.0001），之后保持不变。严重低血糖事件从0.31±0.07/年降至0.09±0.02/年（P<0.003），酮症酸中毒事件也从0.41±0.12/年降至0.11±0.03/年（P<0.013）。在治疗的第一年，每日胰岛素需求量从49±1单位/天降至42±2单位/天（P<0.0001），此后未再改变。每年的门诊就诊次数和住院次数也显著减少。CSII与体重逐渐增加（P<0.05）以及每年每位患者输注部位发生0.2±0.04次感染相关。72%的感染被评为轻度，18%为中度，10%为重度。患者报告CSII改善了代谢控制（71%）、健康状况（41%），并给予了更多自由（40%）。使用糖尿病生活质量量表（DQOL）评估，CSII治疗7年后患者的生活质量评分为良好（0至100分制下得分为73.0±1.8）。
这项回顾性分析表明，CSII可改善1型糖尿病患者的代谢控制，减少低血糖和酮症酸中毒事件，易于接受，能带来良好的生活质量，并减少门诊就诊次数和住院次数。
