Haidar A, Farid D, St-Yves A, Messier V, Chen V, Xing D, Brazeau A-S, Duval C, Boulet B, Legault L, Rabasa-Lhoret R
Institut de Recherches Cliniques de Montréal, Montreal, Canada; Experimental Medicine, McGill University, Montreal, Canada.
Institut de Recherches Cliniques de Montréal, Montreal, Canada; Experimental Medicine, McGill University, Montreal, Canada.
Diabetes Metab. 2014 Jun;40(3):211-4. doi: 10.1016/j.diabet.2013.12.001. Epub 2014 Mar 19.
We compared post-breakfast closed-loop glucose control either matched with a carbohydrate-matching bolus or a weight-dependent bolus.
Twelve adults with type 1 diabetes consumed a 75 g CHO breakfast on two occasions. In random order, the breakfast was accompanied by a full carbohydrate-matching insulin bolus (8.30 U [7.50 U-11.50 U]) or a partial weight-dependent insulin bolus (0.047 U/kg; 3.45 U [2.95 U-3.75 U]). Postprandial glucose was regulated by sensor-responsive insulin and glucagon delivery.
Glucose control after the weight-dependent bolus was safe and feasible (glucose values returned to pre-prandial levels after 5 h). However, 5-hr incremental area under the curve and percentage of time above 10 mmol/L were lower after the full bolus compared to the partial bolus (IAUC, 2.1 [0.8-4.2] mmol/L/hr vs 8.3 [6.5-11.4] mmol/L/hr; time in hyperglycaemia, 24% [6%-29%] vs 50% [25%-63%]; P < 0.001).
Post-breakfast closed-loop glucose control without carbohydrate counting, but based on weight-dependent bolus is feasible but a carbohydrate-matching bolus provides better glucose control.
NCT01519102.
我们比较了早餐后闭环血糖控制，分别采用与碳水化合物匹配的大剂量胰岛素注射或与体重相关的大剂量胰岛素注射。
12名1型糖尿病成年人分两次食用75克碳水化合物的早餐。随机顺序下，早餐分别搭配完全碳水化合物匹配的胰岛素大剂量注射（8.30单位[7.50单位 - 11.50单位]）或部分体重相关的胰岛素大剂量注射（0.047单位/千克；3.45单位[2.95单位 - 3.75单位]）。餐后血糖通过传感器响应性胰岛素和胰高血糖素输送进行调节。
与体重相关的大剂量胰岛素注射后的血糖控制是安全可行的（5小时后血糖值恢复到餐前水平）。然而，与部分大剂量注射相比，完全大剂量注射后5小时曲线下增量面积和血糖高于10毫摩尔/升的时间百分比更低（曲线下增量面积，2.1[0.8 - 4.2]毫摩尔/升/小时对8.3[6.5 - 11.4]毫摩尔/升/小时；高血糖时间，24%[6% - 29%]对50%[25% - 63%]；P < 0.001）。
不进行碳水化合物计数但基于体重相关大剂量注射的早餐后闭环血糖控制是可行的，但碳水化合物匹配的大剂量注射能提供更好的血糖控制。
NCT01519102。
