Grando Maria Adela, Groat Danielle, Soni Hiral, Boyle Mary, Bailey Marilyn, Thompson Bithika, Cook Curtiss B
1 Department of Biomedical Informatics, Arizona State University, Scottsdale, AZ, USA.
2 Division of Endocrinology, Mayo Clinic Arizona, Scottsdale, AZ, USA.
J Diabetes Sci Technol. 2017 Mar;11(2):240-246. doi: 10.1177/1932296816663746. Epub 2016 Sep 25.
There is a lack of systematic ways to analyze how diabetes patients use their insulin pumps to self-manage blood glucose to compensate for alcohol ingestion and exercise. The objective was to analyze "real-life" insulin dosing decisions occurring in conjunction with alcohol intake and exercise among patients using insulin pumps.
We recruited adult type 1 diabetes (T1D) patients on insulin pump therapy. Participants were asked to maintain their daily routines, including those related to exercising and consuming alcohol, and keep a 30-day journal on exercise performed and alcohol consumed. Thirty days of insulin pump data were downloaded. Participants' actual insulin dosing behaviors were compared against their self-reported behaviors in the setting of exercise and alcohol.
Nineteen T1D patients were recruited and over 4000 interactions with the insulin pump were analyzed. The analysis exposed variability in how subjects perceived the effects of exercise/alcohol on their blood glucose, inconsistencies between self-reported and observed behaviors, and higher rates of blood glucose control behaviors for exercise versus alcohol.
Compensation techniques and perceptions on how exercise and alcohol affect their blood glucose levels vary between patients. Improved individualized educational techniques that take into consideration a patient's unique life style are needed to help patients effectively apply alcohol and exercise compensation techniques.
目前缺乏系统的方法来分析糖尿病患者如何使用胰岛素泵自我管理血糖,以补偿酒精摄入和运动的影响。目的是分析使用胰岛素泵的患者在饮酒和运动时的“实际生活中”胰岛素剂量决策。
我们招募了接受胰岛素泵治疗的成年1型糖尿病(T1D)患者。参与者被要求保持日常习惯,包括与运动和饮酒相关的习惯,并记录30天内进行的运动和饮用的酒精。下载30天的胰岛素泵数据。将参与者在运动和饮酒情况下的实际胰岛素给药行为与其自我报告的行为进行比较。
招募了19名T1D患者,分析了4000多次与胰岛素泵的交互。分析揭示了受试者对运动/酒精对其血糖影响的认知存在差异,自我报告行为与观察到的行为之间存在不一致,以及运动与酒精相比血糖控制行为的发生率更高。
患者之间在补偿技巧以及对运动和酒精如何影响其血糖水平的认知方面存在差异。需要改进个性化教育技巧,考虑患者独特的生活方式,以帮助患者有效应用酒精和运动补偿技巧。