Division of Diabetology, Department of Endocrinology, Medical University of Sofia, Sofia, Bulgaria.
Endocrine. 2022 Mar;75(3):776-780. doi: 10.1007/s12020-021-02913-9. Epub 2021 Oct 25.
The purpose of the present study was to compare the basic glycemic control parameters-HbA1c, CV%, and hypoglycemia, as well as quality of life and depression score in patients with type 1 diabetes using continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI).
324 adult patients with type 1 diabetes-146 using CSII and 178 on MDI, were enrolled in this cross-sectional study. HbA1c was assessed in whole blood by immuno-turbidimetric NGSP certified method. CV% was derived from CGM or was calculated from a 9-point capillary blood glucose profile. Hypoglycemia frequency, severity, and awareness were assessed using Clarke's hypoglycemia questionnaire. Quality of life (QOL) was assessed using a questionnaire by the Psychiatric Research Unit and the CES-D scale.
CSII group compared to MDI group showed significantly lower HbA1c-7.3% (6.6-8.0%) vs 8.2% (7.2-9.6%) (p < 0.0001), lower CV 27.2% (±9.8) vs 34.7% (±11.3) (p < 0.0001), fewer hypoglycemia episodes (p < 0.0001). There was no significant difference in the frequency of severe hypoglycemia, hypoglycemia awareness, QOL, and depression scores between the two groups.
CSII in type 1 diabetes is related to better and more stable glycemic control compared to MDI.
本研究旨在比较使用连续皮下胰岛素输注(CSII)与多次皮下注射(MDI)的 1 型糖尿病患者的基本血糖控制参数-HbA1c、变异系数(CV%)和低血糖,以及生活质量和抑郁评分。
本横断面研究纳入了 324 名成年 1 型糖尿病患者,其中 146 名使用 CSII,178 名使用 MDI。HbA1c 采用免疫比浊法 NGSP 认证方法检测全血中的 HbA1c。CV% 来源于 CGM 或通过 9 点毛细血管血糖谱计算得出。低血糖的频率、严重程度和意识通过 Clarke 低血糖问卷进行评估。生活质量(QOL)使用精神病学研究单位和 CES-D 量表的问卷进行评估。
与 MDI 组相比,CSII 组的 HbA1c 显著更低(7.3%(6.6-8.0%) vs 8.2%(7.2-9.6%)(p<0.0001),CV 更低(27.2%(±9.8) vs 34.7%(±11.3)(p<0.0001),低血糖发作次数更少(p<0.0001)。两组之间严重低血糖发作的频率、低血糖意识、QOL 和抑郁评分无显著差异。
与 MDI 相比,CSII 治疗 1 型糖尿病与更好和更稳定的血糖控制相关。