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1型糖尿病患者采用具有预测性低血糖管理功能的传感器增强泵疗法对低血糖及血糖控制的影响:1年随访

Impact of sensor-augmented pump therapy with predictive low-glucose management on hypoglycemia and glycemic control in patients with type 1 diabetes mellitus: 1-year follow-up.

作者信息

Gómez Ana M, Henao Diana C, Taboada Lucía B, Leguizamón Guillermo, Rondón Martín A, Muñoz Oscar M, García-Jaramillo Maira A, León Vargas Fabián M

机构信息

Pontificia Universidad Javeriana, Bogotá, Colombia; Hospital Universitario San Ignacio, Division of Endocrinology, Bogotá, Colombia.

Pontificia Universidad Javeriana, Bogotá, Colombia; Hospital Universitario San Ignacio, Division of Endocrinology, Bogotá, Colombia.

出版信息

Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2625-2631. doi: 10.1016/j.dsx.2019.07.024. Epub 2019 Jul 11.

DOI:10.1016/j.dsx.2019.07.024
PMID:31405686
Abstract

AIMS

To describe real-life experience with sensor-augmented pump therapy with predictive low-glucose management (SAPT-PLGM), in terms of hypoglycemia and glycemic control after one year of follow-up in T1D patients with hypoglycemia as the main indication of therapy.

METHODS

Retrospective cohort study under real life conditions. Baseline and one-year follow-up variables of glycemic control, hypoglycemia and glycemic variability were compared.

RESULTS

Fifty patients were included, 31 on prior treatment with SAPT with low-glucose suspend (LGS) feature and 19 on multiple dose insulin injections (MDI). Mean HbA1c decreased in the MDI group (8.24%-7.08%; p = 0.0001). HbA1c change was not significant in the SAPT-LGS group. Area under the curve (AUC) below 70 mg/dl improved in both SAPT-LGS and MDI groups while AUC, %time and events below 54 mg/dl decreased in SAPT-LGS group. Glycemic variability improved in the MDI group. Less patients presented severe hypoglycemia with SAPT-PLGM in both groups, however the change was non-significant.

CONCLUSIONS

Under real life conditions, SAPT-PLGM reduced metrics of hypoglycemia in patients previously treaded with MDI and SAPT-LGS without deteriorating glycemic control in SAPT-LGS patients, while improving it in patients treated with MDI.

摘要

目的

描述在以低血糖作为主要治疗指征的1型糖尿病(T1D)患者中,采用具有预测性低血糖管理功能的传感器增强泵治疗(SAPT-PLGM)进行一年随访后的低血糖及血糖控制方面的实际应用经验。

方法

在实际生活条件下进行回顾性队列研究。比较血糖控制、低血糖及血糖变异性的基线和一年随访变量。

结果

纳入50例患者,其中31例之前接受具有低血糖暂停(LGS)功能的SAPT治疗,19例接受多次皮下注射胰岛素(MDI)治疗。MDI组平均糖化血红蛋白(HbA1c)下降(从8.24%降至7.08%;p = 0.0001)。SAPT-LGS组HbA1c变化不显著。SAPT-LGS组和MDI组血糖低于70 mg/dl的曲线下面积(AUC)均有所改善,而SAPT-LGS组血糖低于54 mg/dl的AUC、时间百分比及事件数均减少。MDI组血糖变异性得到改善。两组中采用SAPT-PLGM治疗的严重低血糖患者均减少,但变化无统计学意义。

结论

在实际生活条件下,SAPT-PLGM降低了既往接受MDI和SAPT-LGS治疗患者的低血糖指标,在SAPT-LGS患者中未恶化血糖控制,而在接受MDI治疗的患者中改善了血糖控制。

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