Scheuing Nicole, Badenhoop Klaus, Borkenstein Martin, Konrad Katja, Lilienthal Eggert, Laubner Katharina, Naeke Andrea, Rami-Merhar Birgit, Thon Angelika, Wiemann Dagobert, Holl Reinhard W
Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany.
Pediatr Diabetes. 2015 Feb;16(1):10-5. doi: 10.1111/pedi.12158. Epub 2014 Jul 2.
In type 1 diabetes (T1D), the use of continuous subcutaneous insulin infusion (CSII) has increased steadily in the last years. Compared with conventional insulin injection regimes, major advantages might be a nearly physiological insulin secretion, lower rates of hypoglycemia, higher flexibility in daily life, and increased quality of life. Data on CSII in cystic fibrosis-related diabetes (CFRD) are scarce.
To analyze current use of insulin pumps in CFRD and compare demographics of pump-treated patients between CFRD and T1D.
Data from the prospective German/Austrian diabetes patient registry on insulin-treated patients with either CFRD (n = 515) or T1D (n = 43 165) aged >10 yr at manifestation of diabetes were analyzed.
A total of 4.1% (n = 21) of CFRD and 17.7% (n = 7647) of T1D patients received insulin pump treatment within the recent year of care (p < 0.001). Pump-treated patients with CFRD had a significantly shorter duration of diabetes [median (Q1 ; Q3 ): 5.8 (2.9; 9.5) vs. 7.8 (4.3; 20.4) yr, p = 0.026] and tended to be younger [22.0 (18.2; 30.1) vs. 24.9 (17.3; 45.9) yr] than pump-treated T1D patients. Age at initiation of CSII seemed to be lower in CFRD [19.2 (16.5; 29.2) vs. 23.3 (14.8; 43.5) yr]. Insulin pump therapy was used slightly more often in male CFRD patients than females (4.7 vs. 3.6%), whereas in T1D the opposite was observed (14.9 vs. 21.2%, p < 0.001). Discontinuation rate of CSII was higher in CFRD than T1D (30.0 vs. 12.7%, p = 0.005).
Despite potential advantages, insulin pump therapy was rarely used among adolescent and young adult CFRD patients.
在1型糖尿病（T1D）中，近年来持续皮下胰岛素输注（CSII）的使用稳步增加。与传统胰岛素注射方案相比，主要优点可能是胰岛素分泌接近生理状态、低血糖发生率较低、日常生活灵活性更高以及生活质量提高。关于囊性纤维化相关糖尿病（CFRD）中CSII的数据很少。
分析CFRD中胰岛素泵的当前使用情况，并比较CFRD和T1D中接受泵治疗患者的人口统计学特征。
分析了来自德国/奥地利前瞻性糖尿病患者登记处的数据，该登记处涉及糖尿病发病时年龄>10岁的胰岛素治疗的CFRD患者（n = 515）或T1D患者（n = 43165）。
在最近一年的治疗中，共有4.1%（n = 21）的CFRD患者和17.7%（n = 7647）的T1D患者接受了胰岛素泵治疗（p < 0.001）。接受泵治疗的CFRD患者的糖尿病病程明显较短[中位数（Q1；Q3）：5.8（2.9；9.5）年 vs. 7.8（4.3；20.4）年，p = 0.026]，且年龄往往比接受泵治疗的T1D患者更小[22.0（18.2；30.1）岁 vs. 24.9（17.3；45.9）岁]。CFRD中开始CSII治疗的年龄似乎更低[19.2（16.5；29.2）岁 vs. 23.3（14.8；43.5）岁]。男性CFRD患者使用胰岛素泵治疗的频率略高于女性（4.7%对3.6%），而在T1D中则观察到相反情况（14.9%对21.2%，p < 0.001）。CFRD中CSII的停用率高于T1D（30.0%对12.7%，p = 0.005）。
尽管胰岛素泵治疗有潜在优势，但在青少年和年轻成人CFRD患者中很少使用。
