Urakami Tatsuhiko
Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo 173-8610, Japan.
J Clin Med. 2023 Jan 18;12(3):781. doi: 10.3390/jcm12030781.
Hypoglycemia is an often-observed acute complication in the management of children and adolescents with type 1 diabetes. It causes inappropriate glycemic outcomes and may impair the quality of life in the patients. Severe hypoglycemia with cognitive impairment, such as a convulsion and coma, is a lethal condition and is associated with later-onset cognitive impairment and brain-structural abnormalities, especially in young children. Therefore, reducing the frequency of hypoglycemia and minimizing the occurrence of severe hypoglycemia are critical issues in the management of children and adolescents with type 1 diabetes. Advanced diabetes technologies, including continuous glucose monitoring and sensor-augmented insulin pumps with low-glucose suspension systems, can reduce the frequency of hypoglycemia and the occurrence of severe hypoglycemia without aggravating glycemic control. The hybrid closed-loop system, an automated insulin delivery system, must be the most promising means to achieve appropriate glycemic control with preventing severe hypoglycemia. The use of these advanced diabetes technologies could improve glycemic outcomes and the quality of life in children and adolescents with type 1 diabetes.
低血糖是1型糖尿病儿童和青少年管理中经常观察到的急性并发症。它会导致血糖结果不理想,并可能损害患者的生活质量。伴有认知障碍(如惊厥和昏迷)的严重低血糖是一种致命状况,且与后期发生的认知障碍和脑结构异常有关,尤其是在幼儿中。因此,减少低血糖发生频率并将严重低血糖的发生降至最低,是1型糖尿病儿童和青少年管理中的关键问题。先进的糖尿病技术,包括持续葡萄糖监测以及带有低血糖暂停系统的传感器增强型胰岛素泵,可在不加重血糖控制的情况下降低低血糖发生频率和严重低血糖的发生率。混合闭环系统作为一种自动胰岛素输送系统,必定是实现适当血糖控制并预防严重低血糖的最有前景的手段。使用这些先进的糖尿病技术可改善1型糖尿病儿童和青少年的血糖结果及生活质量。