ASPIRE家庭研究中低血糖的预测因素及胰岛素输送自动暂停的影响
Predictors of Hypoglycemia in the ASPIRE In-Home Study and Effects of Automatic Suspension of Insulin Delivery.
作者信息
Weiss Ram, Garg Satish K, Bergenstal Richard M, Klonoff David C, Bode Bruce W, Bailey Timothy S, Thrasher James, Schwartz Frank, Welsh John B, Kaufman Francine R
机构信息
Department of Human Metabolism and Nutrition, Hebrew University, and the Department of Pediatrics, Hadassah Medical Center, Jerusalem, Israel.
University of Colorado Denver, Aurora, CO, USA.
出版信息
J Diabetes Sci Technol. 2015 May 18;9(5):1016-20. doi: 10.1177/1932296815586014.
BACKGROUND
Hypoglycemia varies between patients with type 1 diabetes and is the main obstacle to therapy intensification. We investigated known and potential risk factors for hypoglycemia in subjects with type 1 diabetes.
METHOD
In the ASPIRE In-Home study (NCT01497938), a randomized trial of the threshold suspend (TS) feature of sensor-augmented insulin pump (SAP) therapy, subjects' propensity to nocturnal hypoglycemia (NH) was established in a 2-week run-in phase and assessed in a 3-month study phase via continuous glucose monitoring. Categorical variables were tested for association with NH rates in both phases.
RESULTS
Elevated rates of NH were significantly associated with baseline A1C ≤7%, with bolus insulin deliveries unassisted by the bolus estimation calculator, and with assignment to the control group during the study phase.
CONCLUSIONS
Routine use of the TS feature and the bolus estimation calculator are strategies that may reduce the risk of NH.
背景
1型糖尿病患者的低血糖情况因人而异，是强化治疗的主要障碍。我们调查了1型糖尿病患者低血糖的已知和潜在危险因素。
方法
在ASPIRE居家研究（NCT01497938）中，这是一项关于传感器增强型胰岛素泵（SAP）治疗的阈值暂停（TS）功能的随机试验，在为期2周的导入期确定受试者夜间低血糖（NH）的倾向，并在为期3个月的研究期通过持续葡萄糖监测进行评估。对分类变量在两个阶段与NH发生率的相关性进行了测试。
结果
NH发生率升高与基线糖化血红蛋白（A1C）≤7%、未使用大剂量胰岛素估算计算器辅助的大剂量胰岛素输注以及在研究阶段被分配到对照组显著相关。
结论
常规使用TS功能和大剂量胰岛素估算计算器可能是降低NH风险的策略。
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