Matejko Bartłomiej, Kukułka Aneta, Kieć-Wilk Beata, Stąpór Agnieszka, Klupa Tomasz, Malecki Maciej T
Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland.
University Hospital, Kraków, Poland.
Adv Med. 2018 Jun 5;2018:1473160. doi: 10.1155/2018/1473160. eCollection 2018.
Basal insulin (BI) infusion in pump therapy of type 1 diabetes (T1DM) mimics physiological secretion during the night and between meals. The recommended percentage of the total BI to daily insulin dose (termed the %BI) ranges between 30 and 50%. We analyzed whether this recommendation was followed in adults with T1DM from a university center, and whether BI doses were linked with glycemic control.
We included 260 consecutive patients with T1DM (159 women and 101 men) treated with continuous subcutaneous insulin infusion at the Department of Metabolic Diseases, Krakow, Poland. Data were downloaded from patients' pumps and collected from medical records. We analyzed the settings of BI and the association of %BI with HbA1c level. Linear regression was performed.
The mean age of T1DM individuals was 26.6 ± 8.2 years, BMI was 23.1 ± 3.0 kg/m, T1DM duration was 13.3 ± 6.4 years, and HbA1c level was 7.4%. There were 69.6% (=181) of T1DM patients with %BI in the recommended range. The T1DM duration and HbA1c level of patients with a %BI <30% (=23) was 9.5 years and 6.4%, respectively; for a %BI of 30-50%, it was 13.2 years and 7.4%; and for a %BI >50% (=56), it was 15.8 years and 7.8% ( < 0.001 for both three-group comparisons). Multiple regression identified %BI among independent predictors of the HbA1c level.
In this real-life analysis, the recommendations concerning %BI dosing were not followed by almost one-third of adult T1DM patients. Low %BI was associated with better glycemic control; however, this requires further confirmation.
1型糖尿病（T1DM）泵治疗中基础胰岛素（BI）输注模拟夜间和两餐之间的生理分泌。BI占每日胰岛素剂量的推荐百分比（称为%BI）在30%至50%之间。我们分析了来自大学中心的成年T1DM患者是否遵循了这一推荐，以及BI剂量是否与血糖控制相关。
我们纳入了波兰克拉科夫代谢疾病科连续接受持续皮下胰岛素输注治疗的260例T1DM患者（159名女性和101名男性）。数据从患者的胰岛素泵中下载，并从病历中收集。我们分析了BI的设置以及%BI与糖化血红蛋白（HbA1c）水平的关联。进行了线性回归分析。
T1DM患者的平均年龄为26.6±8.2岁，体重指数（BMI）为23.1±3.0kg/m²，T1DM病程为13.3±6.4年，HbA1c水平为7.4%。69.6%（=181）的T1DM患者的%BI在推荐范围内。%BI<30%（=23）的患者的T1DM病程和HbA1c水平分别为9.5年和6.4%；%BI为30 - 50%的患者，分别为13.2年和7.4%；%BI>50%（=56）的患者，分别为15.8年和7.8%（三组比较均P<0.001）。多元回归分析确定%BI是HbA1c水平的独立预测因素之一。
在这项真实生活分析中，近三分之一的成年T1DM患者未遵循关于%BI给药的推荐。低%BI与更好的血糖控制相关；然而，这需要进一步证实。
