Binek Alicja, Rembierz-Knoll Agnieszka, Polańska Joanna, Jarosz-Chobot Przemysława
Department of Pediatrics, Endocrinology and Diabetes, Upper Silesia Centre for Child's Health.
System Engineering Group, The Silesian University of Technology, Gliwice, Poland.
Pediatr Endocrinol Diabetes Metab. 2016 Feb 18;21(2):65-9. doi: 10.18544/PEDM-21.02.0026.
Pump discontinuation is rare. It is estimated that only about 4% of patients return to multiple daily injections (MDI).
To study the factors that influence the decision to stop continuous subcutaneous insulin infusion therapy (CSII).
Analysis of the anonymous questionnaires indicating factors that influenced pump discontinuation and return to the MDI.
30 children (17girls), mean age 14.3yr(± 3,57), at the start of CSII 11.06yr(± 4.01), at discontinuation of pump therapy 13,23yr(±3,82).
The mean duration of pump usage was significantly higher in boys: 3.28yr±2.31 vs 1, 27yr±1.04(p=0.01); mean HbA1c: boys-8.03%±1.03, girls-7.78±1.42. The most frequently reported disconnection reasons were: greater sense of disease (93%), difficulties in doing sports (70%), worse well-being during pump therapy (63%), having to attach the pump to the body (60%), embarrassment (56%), adhesions and pain in the place of needle insertion (50%), difficulties in controlling glycemia during physical exercise, fear (43%), high levels of HbA1c (36%), frequent blood glucose monitoring (26%). Problems with technical operation of the pump or frequent episodes of severe hypoglycemia or ketoacidosis were not reported. Among those who indicated difficulty in controlling glycaemia during physical exercise or infection, the average age at the time of quitting the pump was significantly lower than the rest: 12.3±3.33 vs. 14.69 ±2.82 (p=0.04).
The individual psycho-emotional state of the child and appropriate education are important at the start and continuation of CSII.
停用胰岛素泵的情况较为罕见。据估计，仅有约4%的患者恢复至每日多次注射（MDI）治疗。
研究影响停止持续皮下胰岛素输注治疗（CSII）决策的因素。
对匿名问卷进行分析，这些问卷表明了影响胰岛素泵停用及恢复至MDI治疗的因素。
30名儿童（17名女孩），开始CSII治疗时的平均年龄为11.06岁（±4.01），停用胰岛素泵治疗时的平均年龄为13.23岁（±3.82），平均年龄14.3岁（±3.57）。
男孩使用胰岛素泵的平均时长显著更长：3.28年±2.31 对比1.27年±1.04（p = 0.01）；平均糖化血红蛋白：男孩 - 8.03%±1.03，女孩 - 7.78±1.42。最常报告的停用原因有：疾病感更强（93%）、运动困难（70%）、胰岛素泵治疗期间幸福感较差（63%）、必须将泵附着于身体（60%）、尴尬（56%）、针头插入部位的粘连和疼痛（50%）、体育锻炼期间血糖控制困难、恐惧（43%）、糖化血红蛋白水平高（36%）、频繁血糖监测（26%）。未报告胰岛素泵技术操作问题或频繁发生的严重低血糖或酮症酸中毒情况。在那些表示体育锻炼或感染期间血糖控制困难的人群中，停用胰岛素泵时的平均年龄显著低于其余人群：12.3±3.33对比14.69 ±2.82（p = 0.04）。
在CSII治疗开始及持续过程中，儿童的个体心理情绪状态及适当的教育很重要。
