Nixon R, Folwell R, Pickup J C
Diabetes Research Group, King's College London School of Medicine, Guy's Hospital, London, UK.
Diabet Med. 2014 Oct;31(10):1174-7. doi: 10.1111/dme.12486. Epub 2014 May 20.
To investigate the pattern of changes in HbA1c in people with Type 1 diabetes managed by long-term Continuous subcutaneous insulin infusion.
We studied HbA1c changes using computerized clinic records in 35 adult people with Type 1 diabetes and an elevated HbA1c (≥ 64 mmol/mol, 8.0%) on multiple daily insulin injections, who were then switched to continuous subcutaneous insulin infusion for at least 5 years.
We identified three subgroups with similar baseline HbA1c but different long-term responses to pump therapy: group A--those with improvement followed by deterioration (57%); group B--those with improvement that was sustained throughout the 5 years (31%); and group C-those where HbA1c did not change significantly from baseline (12%). The patients in group C had a higher BMI: 31.0 ± 5.2 vs. 25.9 ± 3.3 vs. 25.2 ± 3.1 kg/m² (group C vs. group A and group B; P = 0.02).
Improved glycaemic control with continuous subcutaneous insulin infusion was maintained over 5 years by 88% of people with Type 1 diabetes in this study, but there were variations in the long-term efficacy, with some people improving and worsening, others maintaining strict control and a few subcutaneous insulin infusion 'non-responders'.
研究长期持续皮下胰岛素输注治疗的1型糖尿病患者糖化血红蛋白（HbA1c）的变化模式。
我们利用计算机化临床记录，研究了35名成年1型糖尿病患者的HbA1c变化情况。这些患者在每日多次注射胰岛素时HbA1c升高（≥64 mmol/mol，8.0%），随后改用持续皮下胰岛素输注至少5年。
我们确定了三个亚组，它们的基线HbA1c相似，但对胰岛素泵治疗的长期反应不同：A组——那些先改善后恶化的患者（57%）；B组——那些在5年期间持续改善的患者（31%）；C组——那些HbA1c与基线相比无显著变化的患者（12%）。C组患者的体重指数较高：分别为31.0±5.2、25.9±3.3和25.2±3.1 kg/m²（C组与A组和B组相比；P = 0.02）。
本研究中88%的1型糖尿病患者通过持续皮下胰岛素输注在5年期间维持了血糖控制的改善，但长期疗效存在差异，一些患者改善后又恶化，另一些患者维持严格控制，还有少数患者对皮下胰岛素输注“无反应”。
