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["速效门冬胰岛素对使用传感器增强型胰岛素泵治疗的 1 型糖尿病儿童和青少年血糖控制的影响"]

[The impact of «faster aspart» on blood glucose control in children and adolescents with type 1 diabetes treated using a sensor-augmented insulin pump].

作者信息

González de Buitrago Amigo Jesús, González García Ana, Díaz Fernández Paula, Fernández Llamas Mercedes, Tejado Bravo María Luz, de Nicolás Jiménez Jorge M, Ferrer Lozano Marta

机构信息

Servicio de Pediatría, Hospital San Pedro de Alcántara, Cáceres, España.

Servicio de Pediatría, Hospital San Pedro de Alcántara, Cáceres, España.

出版信息

An Pediatr (Engl Ed). 2020 Dec 28. doi: 10.1016/j.anpedi.2020.11.002.

Abstract

BACKGROUND AND AIMS

Post-prandial glucose control is essential to achieve metabolic goals in patients with type 1 diabetes mellitus (T1DM). The new «faster aspart» insulin has a pharmacological profile noted for its faster absorption and onset of action, and increased early availability, resulting in improved blood glucose control after meals. The main objective of the study was to analyse the efficacy of «faster aspart» vs. «insulin aspart» in children and adolescents with DM1 on sensor-augmented pump treatment.

PATIENTS AND METHODS

Multicentre, longitudinal and prospective analytical trial evaluating the use of faster aspart insulin for three months in children with T1DM with MiniMed640G® sensor-augmented pumps previously treated with aspart insulin. At the beginning and end of the study the following variables were analysed for subsequent comparison: mean sensor glucose, percentage of time in range, hypoglycaemia and hyperglycaemia, area under the curve (AUC) < 70 and > 180 mg/dL, mean sensor glucose pre and postprandial in main meals, daily insulin requirements, basal/bolus percentage, and HbA1c. Acute complications, adverse events and satisfaction survey were assessed.

RESULTS

The study included 31 patients with a mean of 13.49 ± 2.42 years of age and with T1DM of 7.0 ± 3.67 years of onset. The use of faster aspart was associated with lower time in hyperglycaemia > 180 mg/dL (25.8 ± 11.3 vs. 22.4 ± 9.5; p = 0.011) and > 250 mg/dL (5.2 ± 4.9 vs. 4.0 ± 3.6; p = 0.04), lower AUC > 180 mg/dL (10.8 ± 6.5 vs. 9.3 ± 6.1; p = 0.03), and increased time in range (71.4 ± 10.0 vs. 74.3 ± 9.2; p = 0.03). No significant changes in hypoglycaemia, HbA1c, insulin requirements, and basal/bolus percentages were detected. Faster aspart was safe and well-evaluated by patients and caregivers.

CONCLUSIONS

Faster aspart achieves better glycaemic control by increasing glucose time in range in children and adolescents with T1DM on treatment with sensor-augmented pumps.

摘要

背景与目的

餐后血糖控制对于1型糖尿病(T1DM)患者实现代谢目标至关重要。新型“速效门冬”胰岛素具有吸收更快、起效更快以及早期可用性增加的药理学特性,可改善餐后血糖控制。本研究的主要目的是分析“速效门冬”与“门冬胰岛素”在接受传感器增强型泵治疗的1型糖尿病儿童和青少年中的疗效。

患者与方法

多中心、纵向、前瞻性分析试验,评估在先前使用门冬胰岛素治疗的配备美敦力640G®传感器增强型泵的1型糖尿病儿童中使用速效门冬胰岛素三个月的情况。在研究开始和结束时,分析以下变量以进行后续比较:平均传感器血糖、血糖在目标范围内的时间百分比、低血糖和高血糖情况、曲线下面积(AUC)<70和>180mg/dL、主餐前后的平均传感器血糖、每日胰岛素需求量、基础/餐时胰岛素百分比以及糖化血红蛋白(HbA1c)。评估急性并发症、不良事件和满意度调查。

结果

该研究纳入了31例患者,平均年龄为13.49±2.42岁,1型糖尿病病程为7.0±3.67年。使用速效门冬胰岛素与高血糖>180mg/dL(25.8±11.3对22.4±9.5;p=0.011)和>250mg/dL(5.2±4.9对4.0±3.6;p=0.04)的时间降低、AUC>180mg/dL降低(10.8±6.5对9.3±~6.1;p=0.03)以及血糖在目标范围内的时间增加(71.4±10.0对74.3±9.2;p=0.03)相关。未检测到低血糖、HbA1c、胰岛素需求量和基础/餐时胰岛素百分比的显著变化。速效门冬胰岛素安全,患者和护理人员对其评价良好。

结论

对于使用传感器增强型泵治疗的1型糖尿病儿童和青少年,速效门冬胰岛素通过增加血糖在目标范围内的时间实现了更好的血糖控制。

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