Department of Pediatrics, Division of Pediatric Endocrinology, Faculty of Medicine, Ege University, Izmir, Turkey.
Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey.
J Pediatr Endocrinol Metab. 2020 Dec 18;34(2):201-207. doi: 10.1515/jpem-2020-0205. Print 2021 Feb 23.
This study aimed to determine the effects of continuous subcutaneous insulin infusion (CSII) treatment on anthropometric measurements, mean HbA1c, and insulin dosage in patients diagnosed under 5 years of age and compare with multiple-dose injection therapy (MDI).
Children with type 1 diabetes mellitus, diagnosed <5 years since 2000 and their 19-year follow-up were evaluated retrospectively. Weight, height, body mass index (BMI), blood pressure, and HbA1c values were recorded for each visit.
Hundred and five patients (58.1% female, 41.9% male) were included in the study. Sixty-three (60 %) patients were treated by CSII and 42 (40%) by MDI. Mean age at diagnosis was 2.68 ± 1.42 and 3.29 ± 1.30 years respectively. Mean follow-up was 7.42 ± 4.76 and 6.01 ± 4.41 years respectively. For each group, weight standard deviation score (SDS) increased significantly in the first year after the diagnosis (p<0.001), and with the onset of puberty weight SDS decreased significantly (p<0.001). The trend of weight and BMI SDS changes over the years showed similar characteristics in both groups. During follow-up height SDS was similar in both groups except in Tanner stage 5. When puberty was completed, mean height SDS was 0.51 ± 1.03 in CSII and -0.31 ± 0.75 in the MDI group (p: 0.029). Mean HbA1c was significantly lower in the CSII group (7.62 ± 0.82 and 8.17 ± 1.22 respectively). Systolic and diastolic blood pressure change trends during the follow-up were also similar in both groups.
CSII treatment had positive effects on metabolic control and height SDS in patients with early-onset diabetes without increasing BMI.
本研究旨在确定连续皮下胰岛素输注（CSII）治疗对诊断年龄小于 5 岁的患者的人体测量学指标、平均 HbA1c 和胰岛素剂量的影响，并与多次注射治疗（MDI）进行比较。
回顾性评估了 2000 年以来诊断为 1 型糖尿病且随访时间达到 19 年的小于 5 岁的儿童患者。每次就诊时记录体重、身高、体重指数（BMI）、血压和 HbA1c 值。
本研究纳入了 105 名患者（58.1%女性，41.9%男性）。63 名（60%）患者接受 CSII 治疗，42 名（40%）患者接受 MDI 治疗。诊断时的平均年龄分别为 2.68±1.42 岁和 3.29±1.30 岁。平均随访时间分别为 7.42±4.76 年和 6.01±4.41 年。对于每个组，诊断后第一年体重标准差评分（SDS）显著增加（p<0.001），并且随着青春期的开始，体重 SDS 显著降低（p<0.001）。两组体重和 BMI SDS 变化的趋势在多年的随访中具有相似的特征。除了 Tanner 5 期之外，两组在随访期间的身高 SDS 相似。当青春期结束时，CSII 组的平均身高 SDS 为 0.51±1.03，MDI 组为-0.31±0.75（p：0.029）。CSII 组的平均 HbA1c 显著较低（分别为 7.62±0.82 和 8.17±1.22）。在随访期间，两组的收缩压和舒张压变化趋势也相似。
CSII 治疗对早期发病糖尿病患者的代谢控制和身高 SDS 有积极影响，而不会增加 BMI。
