Tamborlane William V, Pfeiffer Kathryn M, Brod Meryl, Nikolajsen Annie, Sandberg Anna, Peters Anne L, Van Name Michelle
a Department of Pediatrics , Yale School of Medicine , New Haven , CT , USA.
b The Brod Group , Mill Valley , CA , USA.
Curr Med Res Opin. 2017 Apr;33(4):639-645. doi: 10.1080/03007995.2016.1275937. Epub 2017 Jan 24.
Despite the increased popularity of newer, fast-acting bolus insulin treatment options that allow for more flexibility in the timing of bolus insulin dosing in recent years, relatively little is known about people with diabetes who administer bolus insulin at differing times in relation to their meals. The purpose of this study was to investigate bolus insulin dose timing in relation to meals among people with type 1 (T1D) and type 2 (T2D) diabetes, as well as to better understand the characteristics and experiences of people who bolus dose at differing times.
A web-based survey of adults with T1D and T2D treated with bolus insulin therapy in Germany, the UK, and USA was conducted.
A total of 906 respondents completed the survey (39% T1D; 61% T2D). A majority of respondents reported bolus dosing before meals in the previous week (57.0%), followed by after meals (18.9%), with meals (12.7%), and at varying times (11.5%). Compared to respondents who dosed with or after meals, those who dosed before meals were significantly less likely to experience hypoglycemia (before, 55.7%; with, 72.8%; after, 68.7%; p < .001) in the previous week. Respondents who bolus dosed before meals were significantly more likely to perceive bolus dose timing as flexible (45.5%) compared to those who dosed with (27.8%) or after (35.7%) meals (p < .001).
Results show that many people with T1D and T2D dose their bolus insulin with or after meals. Key limitations of all self-report surveys include potential bias in responses and generalizability of findings. However, the study was designed to help mitigate these limitations. The findings have implications for clinicians and suggest opportunities for improving diabetes education and care.
尽管近年来新型速效推注胰岛素治疗方案越来越受欢迎，这类方案在推注胰岛素给药时间上具有更大的灵活性，但对于在不同进餐时间注射推注胰岛素的糖尿病患者，我们了解得相对较少。本研究的目的是调查1型糖尿病（T1D）和2型糖尿病（T2D）患者推注胰岛素与进餐时间的关系，以及更好地了解在不同时间进行推注给药的患者的特征和经历。
对德国、英国和美国接受推注胰岛素治疗的成年T1D和T2D患者进行了一项基于网络的调查。
共有906名受访者完成了调查（39%为T1D；61%为T2D）。大多数受访者报告在前一周在饭前进行推注给药（57.0%），其次是饭后（18.9%）、进餐时（12.7%）和不同时间（11.5%）。与在进餐时或饭后给药的受访者相比，饭前给药的受访者在前一周发生低血糖的可能性显著更低（饭前为55.7%；进餐时为72.8%；饭后为68.7%；p < .001）。与在进餐时（27.8%）或饭后（35.7%）给药的受访者相比，饭前推注给药的受访者显著更有可能认为推注给药时间灵活（45.5%）（p < .001）。
结果表明，许多T1D和T2D患者在进餐时或饭后注射推注胰岛素。所有自我报告调查的主要局限性包括回答中的潜在偏差和研究结果的可推广性。然而，本研究旨在帮助减轻这些局限性。这些发现对临床医生具有启示意义，并为改善糖尿病教育和护理提供了机会。
