Neu A, Lange K, Barrett T, Cameron F, Dorchy H, Hoey H, Jarosz-Chobot P, Mortensen H B, Robert J-J, Robertson K, de Beaufort C
Children's Hospital, University Hospital Tuebingen, Germany.
Department of Medical Psychology OE5430, Hannover Medical School, Germany.
Pediatr Diabetes. 2015 Sep;16(6):402-6. doi: 10.1111/pedi.12275. Epub 2015 Apr 10.
Modern insulin regimens for the treatment of type 1 diabetes are highly individualized. The concept of an individually tailored medicine accounts for a broad variety of different insulin regimens applied. Despite clear recommendations for insulin management in children and adolescents with type 1 diabetes there is little distinctiveness about concepts and the nomenclature is confusing. Even among experts similar terms are used for different strategies. The aim of our review--based on the experiences of the Hvidoere Study Group (HSG)--is to propose comprehensive definitions for current insulin regimens reflecting current diabetes management in childhood and adolescence. The HSG--founded in 1994--is an international group representing 24 highly experienced pediatric diabetes centers, from Europe, Japan, North America and Australia. Different benchmarking studies of the HSG revealed a broad variety of insulin regimens applied in each center, respectively. Furthermore, the understanding of insulin regimens has been persistently different between the centers since more than 20 yr. Not even the terms 'conventional' and 'intensified therapy' were used consistently among all members. Besides the concepts 'conventional' and 'intensified', several other terms for the characterization of insulin regimens are in use: Basal Bolus Concept (BBC), multiple daily injections (MDI), and flexible insulin therapy (FIT) are most frequently used, although none of these expressions is clearly or consistently defined. The proposed new classification for insulin management will be comprehensive, simple, and catchy. Currently available terms were included. This classification may offer the opportunity to compare therapeutic strategies without the currently existing confusion on the insulin regimen.
用于治疗1型糖尿病的现代胰岛素治疗方案高度个体化。个体化定制药物的概念涵盖了广泛应用的各种不同胰岛素治疗方案。尽管对于1型糖尿病儿童和青少年的胰岛素管理有明确的建议，但在概念方面几乎没有明显区别，且术语命名令人困惑。即使在专家中，不同的策略也使用类似的术语。基于Hvidoere研究小组（HSG）的经验，我们本次综述的目的是为当前胰岛素治疗方案提出全面的定义，以反映儿童和青少年时期当前的糖尿病管理情况。HSG成立于1994年，是一个国际组织，代表着来自欧洲、日本、北美和澳大利亚的24个经验丰富的儿科糖尿病中心。HSG的不同基准研究分别揭示了每个中心应用的广泛的胰岛素治疗方案。此外，20多年来各中心对胰岛素治疗方案的理解一直存在差异。甚至“传统”和“强化治疗”这两个术语在所有成员中也没有一致使用。除了“传统”和“强化”概念外，还有其他几个用于描述胰岛素治疗方案的术语：基础加餐概念（BBC）、多次皮下注射（MDI）和灵活胰岛素治疗（FIT）使用最为频繁，尽管这些表述都没有明确或一致的定义。提议的胰岛素管理新分类将全面、简单且易于记忆。纳入了目前可用的术语。这种分类可能提供机会，在不存在当前胰岛素治疗方案混乱的情况下比较治疗策略。
