闭环胰岛素输注治疗 1 型糖尿病成人患者 12 周内胰岛素需求的变异性。
Variability of Insulin Requirements Over 12 Weeks of Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes.
机构信息
Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K. Department of Paediatrics, University of Cambridge, Cambridge, U.K.
Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, U.K. Department of Diabetes and Endocrinology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, U.K.
出版信息
Diabetes Care. 2016 May;39(5):830-2. doi: 10.2337/dc15-2623. Epub 2016 Mar 10.
OBJECTIVE
To quantify variability of insulin requirements during closed-loop insulin delivery.
RESEARCH DESIGN AND METHODS
We retrospectively analyzed overnight, daytime, and total daily insulin amounts delivered during a multicenter closed-loop trial involving 32 adults with type 1 diabetes. Participants applied hybrid day-and-night closed-loop insulin delivery under free-living home conditions over 12 weeks. The coefficient of variation was adopted to measure variability of insulin requirements in individual subjects.
RESULTS
Data were analyzed from 1,918 nights, 1,883 daytime periods and 1,564 total days characterized by closed-loop use over 85% of time. Variability of overnight insulin requirements (mean [SD] coefficient of variation 31% [4]) was nearly twice as high as variability of total daily requirements (17% [3], P < 0.001) and was also higher than variability of daytime insulin requirements (22% [4], P < 0.001).
CONCLUSIONS
Overnight insulin requirements were significantly more variable than daytime and total daily amounts. This may explain why some people with type 1 diabetes report frustrating variability in morning glycemia.
目的
定量分析闭环胰岛素输注过程中胰岛素需求的变异性。
研究设计与方法
我们回顾性分析了一项多中心闭环试验的夜间、日间和全天胰岛素输注量，该试验涉及 32 例 1 型糖尿病患者。参与者在 12 周的时间内，在居家的自由生活条件下，应用混合式日-夜闭环胰岛素输注。采用变异系数来衡量个体患者胰岛素需求的变异性。
结果
对 1,918 个夜间、1,883 个日间和 1,564 个全天的闭环使用时间超过 85%的数据进行了分析。夜间胰岛素需求的变异性（平均值[标准差]变异系数为 31%[4]）几乎是全天胰岛素需求变异性（17%[3]，P<0.001）的两倍，也高于日间胰岛素需求的变异性（22%[4]，P<0.001）。
结论
夜间胰岛素需求的变异性明显大于日间和全天的胰岛素需求。这可能解释了为什么一些 1 型糖尿病患者报告说早晨血糖波动令人沮丧。
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