Ziegler Ralph, Rees Christen, Jacobs Nehle, Parkin Christopher G, Lyden Maureen R, Petersen Bettina, Wagner Robin S
Diabetes Clinic for Children and Adolescents, Muenster, Germany.
Roche Diagnostics Corporation, Indianapolis, IN, USA.
Pediatr Diabetes. 2016 Aug;17(5):311-8. doi: 10.1111/pedi.12290. Epub 2015 Jun 15.
The relationship between frequency and sustained bolus advisor (BA) use and glycemic improvement has not been well characterized in pediatric populations.
The objective of this study is to assess the impact of frequent and persistent BA use on glycemic control among pediatric type 1 diabetes patients.
In this 6-month, single-center, retrospective cohort study, 104 children [61 girls, mean age: 12.7 yr, mean HbA1c 8.0 (1.6)% [64 (17.5) mmol/mol]], treated with the Accu-Chek Aviva Combo insulin pump, were observed. Frequency of BA use, HbA1c, hypoglycemia (<70 mg/dL), therapy changes, mean blood glucose, and glycemic variability (standard deviation) was assessed at baseline and month 6. Sub-analyses of the adolescent patient use (12 months) and longitudinal use (24 months) were also conducted.
Seventy-one patients reported high frequency (HF) device use (≥50%); 33 reported low frequency (LF) use (<50%) during the study. HF users achieved lower mean (SE) HbA1c levels than LF users: 7.5 (0.1)% [59 (1.1) mmol/mol] vs. 8.0 (0.2)% [64 (2.2) mmol/mol], p = 0.0252. No between-group differences in the percentage of hypoglycemia values were seen at 6 months. HF users showed less glycemic variability (84.0 vs. 94.7, p = 0.0045) than LF users. More HF patients reached HbA1c target of <7.5 at 6 months 66.2% (+16.9) vs. 27.3% (-9.1), p = 0.0056. Similar HbA1c results were seen in adolescents and BA users at 24 months.
Frequent use of the Accu-Chek Aviva Combo insulin pump BA feature was associated with improved and sustained glycemic control with no increase in hypoglycemia in this pediatric population.
在儿科人群中，持续推注辅助装置（BA）的使用频率与血糖改善之间的关系尚未得到充分描述。
本研究的目的是评估频繁且持续使用BA对1型糖尿病患儿血糖控制的影响。
在这项为期6个月的单中心回顾性队列研究中，观察了104名使用安准活力型组合胰岛素泵治疗的儿童[61名女孩，平均年龄：12.7岁，平均糖化血红蛋白（HbA1c）为8.0（1.6）%[64（17.5）mmol/mol]]。在基线和第6个月时评估BA的使用频率、HbA1c、低血糖（<70mg/dL）、治疗变化、平均血糖和血糖变异性（标准差）。还对青少年患者使用情况（12个月）和长期使用情况（24个月）进行了亚组分析。
71名患者报告高频（HF）使用设备（≥50%）；33名患者在研究期间报告低频（LF）使用（<50%）。HF使用者的平均（SE）HbA1c水平低于LF使用者：7.5（0.1）%[59（1.1）mmol/mol]对8.0（0.2）%[64（2.2）mmol/mol]，p = 0.0252。在6个月时，两组之间低血糖值的百分比没有差异。HF使用者的血糖变异性低于LF使用者（84.0对94.7，p = 0.0045）。更多的HF患者在6个月时达到了HbA1c<7.5的目标，分别为66.2%（+16.9）对27.3%（-9.1），p = 0.0056。在24个月时，青少年和BA使用者也有类似的HbA1c结果。
在该儿科人群中，频繁使用安准活力型组合胰岛素泵的BA功能与改善和持续的血糖控制相关，且低血糖发生率没有增加。
