Department of Electrical Engineering and Computer Science, Division of Computer Science and Engineering, University of Michigan, Ann Arbor, MI, USA.
Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA.
J Diabetes Sci Technol. 2022 Sep;16(5):1120-1127. doi: 10.1177/19322968211004171. Epub 2021 Apr 14.
While we expect that patients who adjust their insulin delivery algorithms between clinic visits to have better glucose control compared to those who do not, this effect has not been quantified.
This is a single-center retrospective cohort study including pediatric and adult patients with type 1 diabetes evaluating insulin pump self-management behaviors. Basal insulin dose information was obtained from the Glooko-Diasend database, and used to quantify the frequency and magnitude of basal insulin daily dose adjustments within the 90-day window preceding HbA1c measurement. We use a linear mixed-effects model to analyze associations between frequency/magnitude of daily basal insulin changes and HbA1c.
We present data on 114 adult (44 ± 17 years, 60% female) and 212 pediatric (12 ± 4 years, 50% female) patients. Individuals changed their basal insulin dose on 72%-94% (interquartile range [IQR]) of observed days relative to the previous day. These changes varied 0.6%-2.4% IQR from the previous day's value. In pediatric patients, lower HbA1c was associated with more frequent daily profile adjustments, while controlling for rate of hypoglycemia (z = -3.2, = .001). In adults, there was no relationship between HbA1c and magnitude or frequency of basal profile adjustments.
Pediatric patients who frequently modify their basal insulin exhibit somewhat better clinical outcomes, although the magnitude by which their basal amount is changed does not contribute to this effect.
虽然我们预计在就诊之间调整胰岛素输送算法的患者与未调整的患者相比，血糖控制会更好，但这种效果尚未量化。
这是一项单中心回顾性队列研究，纳入了评估胰岛素泵自我管理行为的 1 型糖尿病儿科和成年患者。基础胰岛素剂量信息来自 Glooko-Diasend 数据库，并用于量化在 HbA1c 测量前 90 天内每日基础胰岛素剂量调整的频率和幅度。我们使用线性混合效应模型分析每日基础胰岛素变化的频率/幅度与 HbA1c 之间的关联。
我们介绍了 114 名成年（44±17 岁，60%女性）和 212 名儿科（12±4 岁，50%女性）患者的数据。个体在前一天的基础上，有 72%-94%（四分位间距 [IQR]）的时间改变了他们的基础胰岛素剂量。这些变化从前一天的值变化了 0.6%-2.4% IQR。在儿科患者中，较低的 HbA1c 与更频繁的日常调整相关，同时控制低血糖的发生率（z=-3.2，=0.001）。在成年人中，HbA1c 与基础轮廓调整的幅度或频率之间没有关系。
频繁调整基础胰岛素的儿科患者表现出稍好的临床结果，尽管他们的基础胰岛素量的变化幅度对这一效果没有贡献。
