Boselli E, Bougnères P F, Couprie C, Chaussain J L
Travail du Service d'Endocrinologie Pédiatrique, Hôpital Saint-Vincent-de-Paul, Paris.
Arch Fr Pediatr. 1987 Nov;44(9):759-64.
Before modern methods of diabetes management were available, the achievement of strict glycemic control was considered almost impossible in most children with early onset of the disease. The present results obtained over 2 years in 31 children aged 21 +/- 2 (SEM) months at the onset of the disease indicate the efficiency of intensive conventional therapy in 21 of them: glycosylated hemoglobin averaged 7.0 +/- 0.3% (N = 4.7 +/- 0.7%) during the observed 26 +/- 7 months, with only 0.02 +/- 0.01 hypoglycemic attack per patient-month and no diabetic ketoacidosis. In the remaining 10 children, who resisted intensive conventional therapy, we used insulin pumps to improve blood glucose control, with the following results over 21 +/- 4 months: Glycosylated hemoglobin decreased from 9.3 +/- 0.3% (before pump) to 8.0 +/- 0.4% (p less than 0.05). The frequency of hypoglycemia decreased dramatically from 1.7 +/- 0.7 to 0.03 +/- 0.01 episode per patient-month. The frequency of ketonuria and ketoacidosis was unchanged. We concluded that intensification of therapy through conventional means, or pump treatment if necessary, allows a long term efficient control of blood glucose in preschool children.
在现代糖尿病管理方法出现之前，对于大多数早发糖尿病儿童而言，实现严格的血糖控制几乎被认为是不可能的。目前对31名发病时年龄为21±2（标准误）个月的儿童进行了为期2年的观察，结果表明其中21名儿童采用强化传统疗法有效：在观察的26±7个月期间，糖化血红蛋白平均为7.0±0.3%（正常范围4.7±0.7%），每位患者每月仅发生0.02±0.01次低血糖发作，且无糖尿病酮症酸中毒。其余10名对强化传统疗法有抵抗的儿童，我们使用胰岛素泵来改善血糖控制，在21±4个月内取得了以下结果：糖化血红蛋白从（使用泵之前的）9.3±0.3%降至8.0±0.4%（p<0.05）。低血糖发作频率从每位患者每月1.7±0.7次显著降至0.03±0.01次。酮尿症和酮症酸中毒的频率没有变化。我们得出结论认为，通过传统方法强化治疗，必要时采用泵治疗，可使学龄前儿童长期有效地控制血糖。
