Quirós Carmen, Patrascioiu Ioana, Giménez Marga, Vinagre Irene, Vidal Mercè, Jansà Margarita, Conget Ignacio
Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Clínic i Universitari de Barcelona, Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, España.
Endocrinol Nutr. 2014 Jun-Jul;61(6):318-22. doi: 10.1016/j.endonu.2014.01.003. Epub 2014 Feb 16.
Patients with type 1 diabetes (T1DM) treated with continuous subcutaneous insulin infusion (CSII) have available several specific features of these devices. The aim of this study was to evaluate the relationship between real use of them and the degree of glycemic control in patients using this therapy.
Forty-four T1DM patients on CSII therapy with or without real-time continuous glucose monitoring (CGM) were included. Data from 14 consecutive days were retrospectively collected using the therapy management software CareLink Personal/Pro(®) and HbA1c measurement performed at that period. The relationship between the frequency of usie of specific features of insulin pumps (non-sensor augmented or sensor-augmented) and glycemic control was analyzed.
Mean HbA1c in the group was 7.5 ± .8%. Mean daily number of boluses administered was 5.1 ± 1.8, with 75.4% of them being bolus wizards (BW). Daily number of boluses was significantly greater in patients with HbA1c <7.5% than in those with HbA1c>7.5% (5.3 ± 1.6 vs. 4.3 ± 1.6, P=.056). There was a trend to greater use of BW in patients with better control (82.8 ± 21.4% vs. 69.9 ± 29.1%, P=.106). HbA1c was lower in patients using CGM (n=8) as compared to those not using sensor-augmented pumps (7.6 ± .8 vs 7.1 ± .7, P=.067), but the difference was not statistically significant.
More frequent use of BW appears to be associated to better metabolic control in patients with T1DM using pump therapy. In standard clinical practice, augmentation of insulin pump with CGM may be associated to improved glycemic control.
接受持续皮下胰岛素输注（CSII）治疗的1型糖尿病（T1DM）患者具备这些设备的若干特定特征。本研究的目的是评估这些设备的实际使用情况与接受该治疗的患者血糖控制程度之间的关系。
纳入44例接受CSII治疗且使用或未使用实时连续血糖监测（CGM）的T1DM患者。使用治疗管理软件CareLink Personal/Pro(®)回顾性收集连续14天的数据，并在该时间段内进行糖化血红蛋白（HbA1c）测量。分析胰岛素泵特定功能（非传感器增强型或传感器增强型）的使用频率与血糖控制之间的关系。
该组患者的平均HbA1c为7.5±0.8%。平均每日注射胰岛素次数为5.1±1.8次，其中75.4%为胰岛素注射向导（BW）。HbA1c<7.5%的患者每日注射次数显著多于HbA1c>7.5%的患者（5.3±1.6次对4.3±1.6次，P=0.056）。血糖控制较好的患者使用BW的趋势更明显（82.8±21.4%对69.9±29.1%，P=0.106）。与未使用传感器增强型泵的患者相比，使用CGM的患者（n=8）HbA1c较低（7.6±0.8对7.1±0.7，P=0.067），但差异无统计学意义。
在接受泵治疗的T1DM患者中，更频繁使用BW似乎与更好的代谢控制相关。在标准临床实践中，胰岛素泵联合CGM可能与改善血糖控制相关。
