Pańkowska Ewa, Szypowska Agnieszka, Lipka Maria, Skórka Agata
Department of Diabetology and Birth Defects, the Medical University of Warsaw, Poland.
Acta Paediatr. 2007 Jun;96(6):881-4. doi: 10.1111/j.1651-2227.2007.00301.x.
To evaluate the safety and efficacy of continuous subcutaneous insulin infusion (CSII) in children under 7 years of age.
One hundred and ten children, aged 0.9-7 years, who had received CSII therapy for at least 6 months, were studied for 237 patient-years by a retrospective chart review. Charts were reviewed for glycosylated hemoglobin (HbA1c), severe hypoglycaemia (SH), ketoacidosis (DKA), height, weight and insulin requirement. In 69 cases (children aged 1.6-7 years) CSII was administered after at least 3 months of insulin therapy with pens. In this group, data from the year from before CSII administration were compared with values recorded during 1 year of CSII treatment.
Mean HbA1c decreased from 7.8 +/- 0.9 before CSII to 7.5 +/- 1.0 after 6 and 12 months of pump therapy (p = 0.04). In the whole group, the mean HbA1c after 6 months of CSII was 7.5 +/- 1.0 and remained unchanged for up to 4 years of follow-up. Some episodes of SH--4.2 per 100 patient-years, and DKA--5.7 per 100 patient-years were recorded. No increase in BMI z-score occurred.
In the youngest children, CSII therapy lowers HbA1c values and provides sustained metabolic control without increases in hypoglycaemia or ketoacidosis episodes.
评估持续皮下胰岛素输注（CSII）在7岁以下儿童中的安全性和有效性。
对110名年龄在0.9至7岁、接受CSII治疗至少6个月的儿童进行回顾性病历审查，研究时长为237患者年。审查病历以获取糖化血红蛋白（HbA1c）、严重低血糖（SH）、酮症酸中毒（DKA）、身高、体重和胰岛素需求量等信息。在69例（年龄为1.6至7岁）患儿中，在使用笔式胰岛素治疗至少3个月后给予CSII治疗。在该组中，将CSII治疗前一年的数据与CSII治疗1年期间记录的值进行比较。
泵治疗6个月和12个月后，平均HbA1c从CSII治疗前的7.8±0.9降至7.5±1.0（p = 0.04）。在整个组中，CSII治疗6个月后的平均HbA1c为7.5±1.0，在长达4年的随访中保持不变。记录到一些SH发作——每100患者年4.2次，以及DKA发作——每100患者年5.7次。BMI z评分没有增加。
在最小的儿童中，CSII治疗可降低HbA1c值，并提供持续的代谢控制，而不会增加低血糖或酮症酸中毒发作的次数。
