一项随机试验中老年1型糖尿病患者驾驶过程中自动胰岛素输送效果

IF 5.7 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes technology & therapeutics Pub Date : 2025-02-01 Epub Date: 2024-12-02 DOI:10.1089/dia.2024.0303
Steven Trawley, Hye Jin Kwon, Sara Vogrin, Peter G Colman, Spiros Fourlanos, Melissa H Lee, Richard J MacIsaac, David N O'Neal, Niamh A O'Regan, Vijaya Sundararajan, Glenn M Ward, Sybil A McAuley
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引用次数: 0

摘要

1型糖尿病(T1D)驾驶员的血糖异常与驾驶性能受损有关,对于接受胰岛素治疗的驾驶员,通常建议血糖水平“高于5才能驾驶”。支持驾驶时血糖正常的糖尿病治疗的证据很少,特别是对于老年司机。在这项随机交叉试验中,研究人员招募了年龄≥60岁的T1D患者,在驾驶过程中使用连续血糖监测(CGM)来比较第一代闭环自动胰岛素输送(AID)和传感器增强泵治疗。8名司机共完成1894次行程(中位年龄68岁[IQR: 64-70])。与传感器增强泵相比,AID在>5.0-10.0 mmol/L范围内的时间更长(100% [0-100]vs. 81% [0-100];P = 0.033),更少的行程CGM为16.7 mmol/L (3.5% vs. 6.4%;P = 0.006)。3%的旅行包括CGM (P = 0.52)。系统警报在所有行程中占10%,没有阶段差异(9% vs 11%;P = 0.078)。第一代AID可降低老年T1D患者的高血糖驾驶,而不会增加低血糖。开发专门的“驾驶模式”设置可以优先考虑安全,同时最大限度地减少分心。试验注册:ACTRN12619000515190。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Automated Insulin Delivery Effects During Driving Among Older Adults with Type 1 Diabetes in a Randomized Trial.

Dysglycemia among drivers with type 1 diabetes (T1D) is associated with impaired driving performance, and glucose levels "above 5 to drive" are often recommended for insulin-treated drivers. Evidence for diabetes treatments that support euglycemia while driving is minimal, particularly for older drivers. In this randomized, crossover trial involving adults aged ≥60 years with T1D, we used continuous glucose monitoring (CGM) during driving to compare the first-generation closed-loop automated insulin delivery (AID) versus a sensor-augmented pump therapy. There were 1894 trips undertaken by 8 drivers (median age 68 years [IQR: 64-70]). During AID versus sensor-augmented pump, time in range >5.0-10.0 mmol/L was greater (100% [0-100] vs. 81% [0-100]; P = 0.033) and fewer trips had any CGM >16.7 mmol/L (3.5% vs. 6.4%; P = 0.006). Three percent of all trips included CGM <3.9 mmol/L, with no between-stage difference (3.0% vs. 3.5%; P = 0.52). System alerts occurred in 10% of all trips, with no between-stage difference (9% vs. 11%; P = 0.078). First-generation AID reduces hyperglycemic driving among older drivers with T1D, without increasing hypoglycemia. Developing dedicated "driving-mode" settings could prioritize safety while minimizing distraction. Trial Registration: ACTRN12619000515190.

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来源期刊
Diabetes technology & therapeutics
Diabetes technology & therapeutics 医学-内分泌学与代谢
CiteScore
10.60
自引率
14.80%
发文量
145
审稿时长
3-8 weeks
期刊介绍: Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.
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