1型糖尿病青少年最优胰岛素治疗模式

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL
G. A. Galkina, A. A. Voropay, M. Levkovich, S. V. Vorobiov, M. V. Komkova, N. V. Morozova
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引用次数: 0

摘要

本研究旨在确定泵胰岛素治疗方案的特殊性,并揭示在1型糖尿病(T1DM)青少年中实现最佳血糖控制所必需的最佳基础与剂量胰岛素比。82名14-18岁的T1DM青少年,连续皮下胰岛素输注(CSII) 5个月至7.5年,使用连续血糖监测(CGM)系统“guardian -dian Real Time”或CGM系统进行监测,该系统采用MiniMed Paradigm Revel system 722(美顿力MiniMed,美国)。评估血糖控制的质量是基于糖化血红蛋白(HbA1c)的水平。对CGM试验结果进行回顾,并对3天的性能进行平均:测定每日胰岛素总剂量、基础胰岛素和单剂量胰岛素、基础胰岛素与单剂量胰岛素的比值、膳食碳水化合物含量、BE表达、碳水化合物比值、胰岛素敏感因子。患者再分为2组:1组-血糖控制最佳/次优的青少年(n = 55), 2组-长期控制不良的T1DM青少年(n = 27)。青少年组1的日均基础胰岛素总剂量(U in a day, U per kg in a day)显著高于组2 (r = 0.043;分别为0.038)。第二组患者在用餐时摄入更多的碳水化合物,并且每天平均总胰岛素剂量更高。1组患者的平均盐丸比为51/49%,而2组患者为45/55% (χ = 0.026)。实现最佳血糖控制的一个重要条件是青少年的高水平依从性和技能。经CSII治疗的T1DM青少年的最佳平衡基础胰岛素与胰岛素比为51/49%,这可以改善血糖管理并降低疾病并发症的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Оптимальные режимы базис-болюсной инсулинотерапии у подростков с сахарным диабетом 1-го типа
This study was aimed to determine peculiarities in regimens of the pump insulin therapy and to reveal the optimal basal-to-bolus insulin ratio that are necessary for achieving optimal glycemic control in adoles-cents with type 1 diabetes mellitus (T1DM).  82 adolescents at the age of 14–18 with T1DM, using continuous subcutaneous insulin infusion (CSII) from 5 months to 7.5 years were monitored with continuous glucose monitoring (CGM) system «Guar-dian Real Time» or CGM system, built in MiniMed Paradigm Revel System 722 (Medtronic Minimed, USA). Assessing the quality of glycaemic control was based on the level of glycated haemoglobin (HbA1c). The results of CGM were reviewed and average for 3 days performances: total daily dose of insulin, dose of basal and bolus insulin, basal-to-bolus insulin ratio, carbohydrate content of the meal, expressed in BE, carbohydrate ratio, insulin sensitivity factor were determined. The patients were subdivided into 2 groups: group 1 – adolescents with the optimal/suboptimal glycemic control ( n = 55), 2 – adolescents with long-standing poorly controlled T1DM ( n = 27). Average total daily dose of basal insulin (U in a day, U per kg in a day) in adolescents group 1 was significantly higher, com-pared with patients in group 2 ( р = 0.043; р = 0.038 respectively). Patients in group 2 received more car-bohydrates with a meal intake and had higher doses of average total daily bolus insulin. The average ba-sal-to-bolus ratio from group 1 patients was 51/49%, compared with group 2 patients – 45/55% ( р = 0.026).  An important condition for achieving optimal glycemic control is a high level of compliance and skills of adolescents. Optimal well-balanced basal-to-bolus insulin ratio in adolescents with T1DM on CSII, which can provide improvements in blood glucose management and reducing the risk of complications of the disease, is 51/49%.
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来源期刊
Byulleten Sibirskoy Meditsiny
Byulleten Sibirskoy Meditsiny MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
50.00%
发文量
102
审稿时长
8 weeks
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