Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, China.
The Second Hospital of Jilin University, No. 218, Ziqiang Street, Nanguan District, Changchun, Jilin Province, China.
Diabetes Metab. 2017 Sep;43(4):359-363. doi: 10.1016/j.diabet.2016.12.009. Epub 2017 Feb 21.
Sensor-augmented pump (SAP) technology, which combines continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (RT-CGM), has been available for several years in China. In this study, the time required to reach predefined glycaemic targets with SAP vs multiple daily injection (MDI) therapy was compared in hospitalized patients with type 2 diabetes mellitus (T2DM).
Adults (aged 18-65 years) with T2DM treated with insulin and admitted to hospital for glucose management were randomized to either SAP (Medtronic MiniMed™ Paradigm™ 722 system) or MDI with blinded CGM (Medtronic MiniMed CGMS System Gold™) for a 2-week period. Glycaemic targets were defined as three preprandial measurements between 80 and 130mg/dL (4.4 and 7.2mmol/L) and three 2-h postprandial measurements between 80 and 180mg/dL (4.4 and 10.0mmol/L) within the same day.
When data from 81 patients (40 SAP, 41 MDI) were analysed, 21 patients using SAP therapy, compared with six using MDI therapy, achieved their glycaemic targets within 3 days, and their time to reach their glucose targets was significantly shorter (3.7±1.1 vs 6.3±3.1 days for MDI; P<0.001), while three MDI patients failed to reach glycaemic targets within 14 days. SAP vs MDI patients experienced significantly less hypoglycaemia [sensor glucose<50mg/dL (2.8mmol/L): 0.04% vs 0.32%, respectively; P<0.05] and significantly less hyperglycaemia [sensor glucose>180mg/dL (10mmol/L): 21.56% vs 35.03%, respectively; P<0.05].
SAP vs MDI therapy in hospitalized patients with T2DM significantly reduced the time required to achieve glycaemic targets, and such systems may be a cost-effective way to improve glucose control and reduce hospital stays in T2DM patients.
传感器增强型胰岛素泵（SAP）技术结合了持续皮下胰岛素输注（CSII）和实时连续血糖监测（RT-CGM），已在中国应用了数年。在这项研究中，比较了 SAP 与多次皮下注射（MDI）治疗在住院 2 型糖尿病（T2DM）患者中达到预设血糖目标所需的时间。
接受胰岛素治疗并因血糖管理而住院的成年（18-65 岁）T2DM 患者随机分为 SAP（美敦力 MiniMed™ Paradigm™ 722 系统）或 MDI 联合盲法 CGM（美敦力 MiniMed CGMS System Gold™）组，治疗期为 2 周。血糖目标定义为同一天内三次餐前测量值在 80-130mg/dL（4.4-7.2mmol/L）之间，三次餐后 2 小时测量值在 80-180mg/dL（4.4-10.0mmol/L）之间。
分析了 81 例患者（40 例 SAP，41 例 MDI）的数据，21 例使用 SAP 治疗的患者在 3 天内达到了血糖目标，而他们达到血糖目标的时间明显缩短（SAP 组为 3.7±1.1 天，MDI 组为 6.3±3.1 天；P<0.001），而 3 例 MDI 患者在 14 天内未达到血糖目标。SAP 组患者的低血糖发生率[传感器血糖<50mg/dL（2.8mmol/L）：0.04% vs 0.32%；P<0.05]和高血糖发生率[传感器血糖>180mg/dL（10mmol/L）：21.56% vs 35.03%；P<0.05]均明显低于 MDI 组。
与 MDI 治疗相比，SAP 治疗住院 T2DM 患者可显著缩短达到血糖目标所需的时间，这些系统可能是一种具有成本效益的方法，可改善血糖控制并缩短 T2DM 患者的住院时间。
