CHU-Hôpitaux Sud, 270 boulevard de Sainte Marguerite, 13009 Marseille, France.
Diabetes Technol Ther. 2011 Jun;13(6):657-60. doi: 10.1089/dia.2010.0209. Epub 2011 Apr 6.
This article reports a prolonged trial with insulin pumps implanted in patients with type 1 diabetes showing poor glucose control and a high rate of complications.
We reviewed data from 181 patients undergoing implanted insulin pump therapy. Analysis included hemoglobin A1c (HbA1c) values, body weight, and diabetes complications status.
At implantation, the mean age was 43 (range, 19-72) years, mean duration of diabetes was 22.2 (2-52) years, and mean body weight was 68.6 (43-104) kg. The complication status involved retinopathy (62% of patients), neuropathy (34.6%), nephropathy (26%), and cardiovascular disease (14%). Patients' previous insulin treatment regimen was multiple daily injections (17.1%) or continuous subcutaneous insulin infusion (82.9%). HbA1c levels significantly dropped from 7.9 ± 1.2% to 7.6 ± 1.2% after 1 year (P < 0.01) and remained within the range of 7.5-7.6% for up to 5 years. No significant variation of body weight or complications status occurred.
Implanted insulin pump therapy demonstrates long-term benefits in type 1 diabetes patients who have poor prognosis under intensive subcutaneous treatment.
本文报告了一项对 181 例 1 型糖尿病患者进行胰岛素泵植入的长期试验，这些患者血糖控制不佳且并发症发生率较高。
我们回顾了 181 例行植入胰岛素泵治疗患者的数据。分析包括糖化血红蛋白（HbA1c）值、体重和糖尿病并发症状况。
植入时，患者平均年龄为 43 岁（范围 19-72 岁），糖尿病病程平均为 22.2 年（范围 2-52 年），平均体重为 68.6kg（范围 43-104kg）。并发症状况涉及视网膜病变（62%的患者）、神经病变（34.6%）、肾病（26%）和心血管疾病（14%）。患者既往胰岛素治疗方案为多次皮下注射（17.1%）或持续皮下胰岛素输注（82.9%）。HbA1c 水平在 1 年后从 7.9±1.2%显著下降至 7.6±1.2%（P<0.01），并在 5 年内保持在 7.5-7.6%的范围内。体重或并发症状况无明显变化。
在皮下强化治疗预后不佳的 1 型糖尿病患者中，植入胰岛素泵治疗具有长期益处。
