Steier Yossi, Cohen-Sela Eyal, Averbauch Shay, Oren Asaf, Eyal Ori, Lebenthal Yael, Brener Avivit
Isr Med Assoc J. 2025 Jul;27(7):411-416.
The Iron Swords war created stressful circumstances that could negatively impact glycemic control in individuals with type 1 diabetes (T1D).
To evaluate changes in continuous glucose monitoring (CGM) metrics in pediatric T1D patients during the war.
This retrospective study included T1D patients monitored by CGM. Metrics from three selected 2-week periods were compared (before the war, after the war outbreak, and 4 months later). Study variables included time-in-range (70-180 mg/dl; 3.9-10 mmol/L), time-in-tight-range (70-140 mg/dl; 3.9-7.8 mmol/L), time-in-marked-hypoglycemia (< 54 mg/dl; < 3 mmol/liter), and time-in-severe-hyperglycemia (> 250 mg/dl; >13.3 mmol/liter). Patients were treated with either a multiple daily insulin (MDI) regimen or insulin pump, with or without an open-source automated insulin delivery (OS-AID) system.
Data of 99 patients were analyzed (mean age 12.2 ± 4.0 years, mean diabetes duration 4.6 ± 3.9 years, 52.5% males). No significant changes in CGM metrics were observed across the entire cohort at any time point. Patients with higher socioeconomic position (SEP; cluster > 7) had better CGM metrics, with an increase in time-in-tight-range in the lower SEP group and in time-in-severe-hyperglycemia in the higher SEP group (P = 0.003). OS-AID users (n=20) had superior pre-war CGM metrics and maintained stable glycemia during the war, MDI users showed increased time-in-severe-hyperglycemia post-outbreak (P = 0.05).
Throughout the war, children and adolescents with T1D treated with insulin pumps maintained relatively stable glycemic control. Susceptibility to change following the onset of war was influenced by SEP and mode of insulin therapy.
铁剑战争造成了压力环境，可能对1型糖尿病（T1D）患者的血糖控制产生负面影响。
评估战争期间儿科T1D患者连续血糖监测（CGM）指标的变化。
这项回顾性研究纳入了通过CGM监测的T1D患者。比较了三个选定的两周时间段的指标（战前、战争爆发后和4个月后）。研究变量包括血糖达标时间（70-180 mg/dl；3.9-10 mmol/L）、严格血糖达标时间（70-140 mg/dl；3.9-7.8 mmol/L）、显著低血糖时间（<54 mg/dl；<3 mmol/L）和严重高血糖时间（>250 mg/dl；>13.3 mmol/L）。患者接受多次每日胰岛素（MDI）方案或胰岛素泵治疗，有或没有开源自动胰岛素输注（OS-AID）系统。
分析了99例患者的数据（平均年龄12.2±4.0岁，平均糖尿病病程4.6±3.9年，52.5%为男性）。在任何时间点，整个队列的CGM指标均未观察到显著变化。社会经济地位较高（SEP；聚类>7）的患者CGM指标较好，较低SEP组的严格血糖达标时间增加，较高SEP组的严重高血糖时间增加（P = 0.003）。OS-AID使用者（n = 20）战前CGM指标较好，战争期间血糖维持稳定，MDI使用者在战争爆发后严重高血糖时间增加（P = 0.05）。
在整个战争期间，接受胰岛素泵治疗的T1D儿童和青少年维持了相对稳定的血糖控制。战争爆发后血糖变化的易感性受SEP和胰岛素治疗方式的影响。
