使用连续血糖监测仪评估胰岛移植后非胰岛素依赖型与胰岛素依赖型1型糖尿病受试者的血糖控制情况。

Assessment of glycemic control after islet transplantation using the continuous glucose monitor in insulin-independent versus insulin-requiring type 1 diabetes subjects.

作者信息

Paty Breay W, Senior Peter A, Lakey Jonathan R T, Shapiro A M James, Ryan Edmond A

机构信息

Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.

出版信息

Diabetes Technol Ther. 2006 Apr;8(2):165-73. doi: 10.1089/dia.2006.8.165.

DOI:10.1089/dia.2006.8.165

PMID:16734547

Abstract

BACKGROUND

The aim of this study was to assess and compare glycemic control using the continuous glucose monitor (CGMS, Medtronic Minimed, Northridge, CA) in type 1 diabetes mellitus (T1DM) subjects who are insulin-independent versus those who require insulin after islet transplantation alone (ITA).

METHODS

Glycemic control was assessed using 72-h CGMS in eight T1DM subjects who were insulin-independent after ITA (ITA-II), eight T1DM subjects who were C-peptide-positive but insulin-requiring after ITA (ITA-IR), and eight non-transplanted (NT) T1DM subjects.

RESULTS

Standard deviation of glucose values was not significantly different between ITA-II and ITA-IR subjects (ITA-II, 1.2 +/- 0.1 mM; ITA-IR, 2.0 +/- 0.3 mM; P = 0.072). Both ITA groups were more stable than NT subjects (NT, 3.3 +/- 0.3 mM; P = 0.001 vs. ITA). Mean high glucose values were significantly lower in ITA subjects compared with NT subjects (ITA-II, 10.5 +/- 0.6 mM; ITA-IR, 13.0 +/- 1.0 mM; NT, 16.1 +/- 1.1 mM; P = 0.002). Mean average glucose values were not significantly different among all groups (ITA-I, 6.7 +/- 0.2 mM; ITA-IR, 7.8 +/- 0.3 mM; NT, 7.7 +/- 0.6 mM; P = 0.198). Mean low glucose values were significantly higher in both ITA groups compared with NT subjects (ITA-II, 4.5 +/- 0.2 mM; ITA-IR, 4.3 +/- 0.3 mM; NT, 3.0 +/- 0.2 mM; P = 0.003). Duration of hypoglycemic excursions (<3.0 mM) was markedly reduced in both ITA groups (ITA-II, 0%; ITA-IR, 2.4 +/- 0.2%; NT, 11.8 +/- 4.2%). Glycated hemoglobin was not significantly different between ITA groups (ITA-II, 6.4 +/- 0.2%; ITA-IR, 6.5 +/- 0.3%) and was significantly higher in NT subjects (8.3 +/- 0.2%; P < 0.001 vs. ITA).

CONCLUSIONS

CGMS monitoring demonstrates that glycemic lability and hypoglycemia are significantly reduced in C-peptide-positive islet transplant recipients, whether or not supplementary, exogenous insulin is used, compared with non-transplanted T1DM subjects.

摘要

背景

本研究旨在评估和比较使用连续血糖监测系统（CGMS，美敦力公司，加利福尼亚州北岭）对1型糖尿病（T1DM）患者进行血糖控制的情况，这些患者分为不依赖胰岛素组和仅接受胰岛移植（ITA）后需要胰岛素组。

方法

使用72小时CGMS对8名ITA后不依赖胰岛素的T1DM患者（ITA-II）、8名ITA后C肽阳性但需要胰岛素的T1DM患者（ITA-IR）和8名未移植的（NT）T1DM患者进行血糖控制评估。

结果

ITA-II组和ITA-IR组患者的血糖值标准差无显著差异（ITA-II组为1.2±0.1 mM；ITA-IR组为2.0±0.3 mM；P = 0.072）。两个ITA组均比NT组更稳定（NT组为3.3±0.3 mM；与ITA组相比P = 0.001）。ITA组患者的平均高血糖值显著低于NT组患者（ITA-II组为10.5±0.6 mM；ITA-IR组为13.0±1.0 mM；NT组为16.1±1.1 mM；P = 0.002）。所有组之间的平均血糖值无显著差异（ITA-I组为6.7±0.2 mM；ITA-IR组为7.8±0.3 mM；NT组为7.7±0.6 mM；P = 0.198）。两个ITA组的平均低血糖值均显著高于NT组患者（ITA-II组为4.5±0.2 mM；ITA-IR组为4.3±0.3 mM；NT组为3.0±0.2 mM；P = 0.003）。两个ITA组的低血糖发作持续时间（<3.0 mM）均明显缩短（ITA-II组为0%；ITA-IR组为2.4±0.2%；NT组为11.8±4.2%）。ITA组之间的糖化血红蛋白无显著差异（ITA-II组为6.4±0.2%；ITA-IR组为6.5±0.3%），且NT组患者的糖化血红蛋白显著更高（8.3±0.2%；与ITA组相比P < 0.001）。