NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia.
Sci Rep. 2021 Aug 17;11(1):16656. doi: 10.1038/s41598-021-95824-8.
To determine whether continuous subcutaneous insulin infusion (CSII) vs. multiple daily injections (MDI) therapy from near-diagnosis of type 1 diabetes is associated with reduced glycaemic variability (GV) and altered microRNA (miRNAs) expression. Adolescents (74% male) within 3-months of diabetes diagnosis (n = 27) were randomized to CSII (n = 12) or MDI. HbA1c, 1-5-Anhydroglucitol (1,5-AG), high sensitivity C-peptide and a custom TaqMan qPCR panel of 52 miRNAs were measured at baseline and follow-up (median (LQ-UQ); 535 (519-563) days). There were no significant differences between groups in baseline or follow-up HbA1c or C-peptide, nor baseline miRNAs. Mean ± SD 1,5-AG improved with CSII vs. MDI (3.1 ± 4.1 vs. - 2.2 ± - 7.0 mg/ml respectively, P = 0.029). On follow-up 11 miRNAs associated with diabetes vascular complications had altered expression in CSII-users. Early CSII vs. MDI use is associated with lower GV and less adverse vascular-related miRNAs. Relationships with future complications are of interest.
为了确定从 1 型糖尿病诊断开始时采用持续皮下胰岛素输注 (CSII) 与多次皮下注射 (MDI) 治疗，哪种方法与降低血糖变异性 (GV) 和改变 microRNA (miRNA) 表达相关。在糖尿病诊断后 3 个月内的青少年（74%为男性）（n=27）被随机分配到 CSII（n=12）或 MDI 组。在基线和随访时（中位数 (LQ-UQ)；535 (519-563) 天），测量了糖化血红蛋白 (HbA1c)、1,5-脱水葡萄糖醇 (1,5-AG)、高敏 C 肽和 52 个 miRNA 的定制 TaqMan qPCR 检测。两组在基线或随访时的 HbA1c 或 C 肽，以及基线 miRNA 方面均无显著差异。CSII 组的 1,5-AG 平均值 ± 标准差比 MDI 组改善（3.1 ± 4.1 与 -2.2 ± -7.0 mg/ml 比较，P=0.029）。在随访时，CSII 使用者中与糖尿病血管并发症相关的 11 个 miRNA 的表达发生改变。与 MDI 相比，早期 CSII 与更低的 GV 和更少的不良血管相关 miRNA 相关。与未来并发症的关系很有趣。
