1型糖尿病患儿及其父母对低血糖和睡眠的恐惧
Fear of hypoglycemia and sleep in children with type 1 diabetes and their parents.
作者信息
Schierloh Ulrike, Aguayo Gloria A, Fichelle Muriel, De Melo Dias Cindy, Schritz Anna, Vaillant Michel, Barnard-Kelly Katharine, Cohen Ohad, Gies Inge, de Beaufort Carine
机构信息
Department of Pediatric Diabetes and Endocrinology, Clinique Pédiatrique, Centre Hospitalier, Luxembourg, Luxembourg.
Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg.
出版信息
Front Endocrinol (Lausanne). 2024 Dec 16;15:1419502. doi: 10.3389/fendo.2024.1419502. eCollection 2024.
AIMS
To compare impact of pump treatment and continuous glucose monitoring (CGM) with predictive low glucose suspend (SmartGuard) or user initiated CGM (iscCGM) on sleep and hypoglycemia fear in children with type 1 Diabetes and parents.
METHODS
Secondary analysis of data from 5 weeks pump treatment with iscCGM (A) or SmartGuard (B) open label, single center, randomized cross-over study was performed. At baseline and end of treatment arms, sleep and fear of hypoglycemia were evaluated using ActiGraph and questionnaires.
RESULTS
31 children (6-14 years, male: 50%) and 30 parents (28-55 years) participated. Total sleep minutes did not differ significantly for children (B vs. A: -9.27; 95% CI [-24.88; 6.34]; p 0.26) or parents (B vs. A: 5.49; 95% CI [-8.79; 19.77]; p 0.46). Neither daytime sleepiness nor hypoglycemia fear in children or parents differed significantly between the systems. Neither group met recommended sleep criteria.
CONCLUSION
Lack of sleep and fear of hypoglycemia remain a major burden for children with diabetes and their parents. Whilst no significant differences between the systems were found, future technology should consider psychosocial impacts of diabetes and related technologies on children and parents' lived experience to ensure parity of esteem between physical and mental health outcomes.
CLINICAL TRIAL REGISTRATION
www.ClinicalTrials.gov, identifier NCT03103867.
目的
比较泵治疗与连续血糖监测（CGM），以及具有预测性低血糖暂停功能（SmartGuard）或用户启动式CGM（iscCGM）对1型糖尿病儿童及其父母睡眠和低血糖恐惧的影响。
方法
对一项开放标签、单中心、随机交叉研究的数据进行二次分析，该研究为使用iscCGM（A组）或SmartGuard（B组）进行5周泵治疗。在治疗组的基线和治疗结束时，使用活动记录仪和问卷对睡眠和低血糖恐惧进行评估。
结果
31名儿童（6 - 14岁，男性占50%）和30名父母（28 - 55岁）参与研究。儿童（B组与A组相比：-9.27；95%置信区间[-24.88；6.34]；p = 0.26）或父母（B组与A组相比：5.49；95%置信区间[-8.79；19.77]；p = 0.46）的总睡眠时间无显著差异。两组系统在儿童或父母的日间嗜睡或低血糖恐惧方面均无显著差异。两组均未达到推荐的睡眠标准。
结论
睡眠不足和低血糖恐惧仍然是糖尿病儿童及其父母的主要负担。虽然未发现两组系统之间存在显著差异，但未来的技术应考虑糖尿病及相关技术对儿童和父母生活体验的社会心理影响，以确保身心健康结果在受重视程度上的平等。
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