Steineck Isabelle, Ranjan Ajenthen, Nørgaard Kirsten, Schmidt Signe
1 Department of Endocrinology, Hvidovre University Hospital, Hvidovre, Denmark.
2 Danish Diabetes Academy, Odense, Denmark.
J Diabetes Sci Technol. 2017 Jan;11(1):50-58. doi: 10.1177/1932296816672689. Epub 2016 Oct 6.
Hypoglycemia can lead to seizures, unconsciousness, or death. Insulin pump treatment reduces the frequency of severe hypoglycemia compared with multiple daily injections treatment. The addition of a continuous glucose monitor, so-called sensor-augmented pump (SAP) treatment, has the potential to further limit the duration and severity of hypoglycemia as the system can detect and in some systems act on impending and prevailing low blood glucose levels. In this narrative review we summarize the available knowledge on SAPs with and without automated insulin suspension, in relation to hypoglycemia prevention. We present evidence from randomized trials, observational studies, and meta-analyses including nonpregnant individuals with type 1 diabetes mellitus. We also outline concerns regarding SAPs with and without automated insulin suspension. There is evidence that SAP treatment reduces episodes of moderate and severe hypoglycemia compared with multiple daily injections plus self-monitoring of blood glucose. There is some evidence that SAPs both with and without automated suspension reduces the frequency of severe hypoglycemic events compared with insulin pumps without continuous glucose monitoring.
低血糖可导致癫痫发作、昏迷或死亡。与每日多次注射治疗相比，胰岛素泵治疗可降低严重低血糖的发生频率。增加持续葡萄糖监测，即所谓的传感器增强泵（SAP）治疗，有可能进一步限制低血糖的持续时间和严重程度，因为该系统能够检测到即将发生和正在发生的低血糖水平，并且在某些系统中还能对其作出反应。在这篇叙述性综述中，我们总结了有关有无自动胰岛素暂停功能的SAP在预防低血糖方面的现有知识。我们展示了来自随机试验、观察性研究以及荟萃分析的证据，这些研究涵盖了非妊娠1型糖尿病患者。我们还概述了对有无自动胰岛素暂停功能的SAP的相关担忧。有证据表明，与每日多次注射加自我血糖监测相比，SAP治疗可减少中度和严重低血糖发作的次数。有一些证据表明，与无持续葡萄糖监测的胰岛素泵相比，有无自动暂停功能的SAP均可降低严重低血糖事件的发生频率。
