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
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.
Diabetes Metab Syndr. 2019 Jul-Aug;13(4):2625-2631. doi: 10.1016/j.dsx.2019.07.024. Epub 2019 Jul 11.
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.
Retrospective cohort study under real life conditions. Baseline and one-year follow-up variables of glycemic control, hypoglycemia and glycemic variability were compared.
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.
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.
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。
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。
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。
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。