1型糖尿病患者转介胰岛素泵专论会诊的中期-长期结果

Marta Botella , José Antonio Rubio , Noelia Peláez , Clara Tasende , María Paz Gomez , Julia Álvarez
{"title":"1型糖尿病患者转介胰岛素泵专论会诊的中期-长期结果","authors":"Marta Botella ,&nbsp;José Antonio Rubio ,&nbsp;Noelia Peláez ,&nbsp;Clara Tasende ,&nbsp;María Paz Gomez ,&nbsp;Julia Álvarez","doi":"10.1016/j.avdiab.2014.12.003","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>To analyse the first 69 type<!--> <!-->1 diabetes patients referred to a specialist team between 2005 and 2012 in order to evaluate the indication for continuous subcutaneous insulin infusion (CSII).</p></div><div><h3>Methods</h3><p>Retrospective, observational, single centre study conducted on 69 adult patients evaluated for CSII. An analysis was made on patients who did not initiate CSII (n<!--> <!-->=<!--> <!-->18) and patients who were treated with CSII (n<!--> <!-->=<!--> <!-->51). Variables included: age, gender, duration of disease, indication for CSII, HbA1c, frequency of severe hypoglycaemia events, episodes of diabetic ketoacidosis, and pump discontinuation.</p></div><div><h3>Results</h3><p>The main reason for not initiating CSII was patient refusal (49%), followed by improving of glycaemic control (33%) after optimising with multiple daily injections (MDI) therapy. The most common CSII indications were: suboptimal glycaemic control (49%), and suboptimal glycaemic control with frequent non-severe hypoglycaemia (27.5%). Baseline HbA1c was 8.6<!--> <!-->±<!--> <!-->1.5%, and there was a significant and sustained decrease of 1% over a 5 year period (<em>P</em> <!-->&lt;<!--> <!-->.001), with this reduction being greater in patients with HbA1c &gt;<!--> <!-->8%. The use of CSII was stopped by 5 patients (10%) after 1 to 6<!--> <!-->years.</p></div><div><h3>Conclusion</h3><p>In our clinical practice one in four patients evaluated for CSII did not initiate it. The switch from MDI to CSII was associated with a 1% reduction in HbA1c over 5<!--> <!-->years, being greater in patients with poor glycaemic control.</p></div>","PeriodicalId":100152,"journal":{"name":"Avances en Diabetología","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.003","citationCount":"0","resultStr":"{\"title\":\"Resultados a medio-largo plazo de pacientes con diabetes tipo 1 remitidos a una consulta monográfica de bombas de insulina\",\"authors\":\"Marta Botella ,&nbsp;José Antonio Rubio ,&nbsp;Noelia Peláez ,&nbsp;Clara Tasende ,&nbsp;María Paz Gomez ,&nbsp;Julia Álvarez\",\"doi\":\"10.1016/j.avdiab.2014.12.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p>To analyse the first 69 type<!--> <!-->1 diabetes patients referred to a specialist team between 2005 and 2012 in order to evaluate the indication for continuous subcutaneous insulin infusion (CSII).</p></div><div><h3>Methods</h3><p>Retrospective, observational, single centre study conducted on 69 adult patients evaluated for CSII. An analysis was made on patients who did not initiate CSII (n<!--> <!-->=<!--> <!-->18) and patients who were treated with CSII (n<!--> <!-->=<!--> <!-->51). Variables included: age, gender, duration of disease, indication for CSII, HbA1c, frequency of severe hypoglycaemia events, episodes of diabetic ketoacidosis, and pump discontinuation.</p></div><div><h3>Results</h3><p>The main reason for not initiating CSII was patient refusal (49%), followed by improving of glycaemic control (33%) after optimising with multiple daily injections (MDI) therapy. The most common CSII indications were: suboptimal glycaemic control (49%), and suboptimal glycaemic control with frequent non-severe hypoglycaemia (27.5%). Baseline HbA1c was 8.6<!--> <!-->±<!--> <!-->1.5%, and there was a significant and sustained decrease of 1% over a 5 year period (<em>P</em> <!-->&lt;<!--> <!-->.001), with this reduction being greater in patients with HbA1c &gt;<!--> <!-->8%. The use of CSII was stopped by 5 patients (10%) after 1 to 6<!--> <!-->years.</p></div><div><h3>Conclusion</h3><p>In our clinical practice one in four patients evaluated for CSII did not initiate it. The switch from MDI to CSII was associated with a 1% reduction in HbA1c over 5<!--> <!-->years, being greater in patients with poor glycaemic control.</p></div>\",\"PeriodicalId\":100152,\"journal\":{\"name\":\"Avances en Diabetología\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/j.avdiab.2014.12.003\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Avances en Diabetología\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1134323014001549\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Avances en Diabetología","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1134323014001549","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

目的分析2005 ~ 2012年收治的69例1型糖尿病患者,探讨持续皮下胰岛素输注(CSII)的适应证。方法对69例成年CSII患者进行回顾性、观察性、单中心研究。对未启动CSII的患者(n = 18)和接受CSII治疗的患者(n = 51)进行分析。变量包括:年龄、性别、疾病持续时间、CSII的适应症、HbA1c、严重低血糖事件的频率、糖尿病酮症酸中毒的发作和停泵。结果未启动CSII的主要原因是患者拒绝(49%),其次是优化每日多次注射(MDI)治疗后血糖控制改善(33%)。最常见的CSII适应症是:次优血糖控制(49%)和次优血糖控制伴频繁非严重低血糖(27.5%)。基线HbA1c为8.6±1.5%,在5年期间显著持续下降1% (P <.001), HbA1c患者的降幅更大;8%。5例患者(10%)在1 ~ 6年后停止使用CSII。结论在我们的临床实践中,四分之一被评估为CSII的患者没有启动它。从MDI到CSII的转换与HbA1c在5年内降低1%相关,在血糖控制不良的患者中更大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Resultados a medio-largo plazo de pacientes con diabetes tipo 1 remitidos a una consulta monográfica de bombas de insulina

Objective

To analyse the first 69 type 1 diabetes patients referred to a specialist team between 2005 and 2012 in order to evaluate the indication for continuous subcutaneous insulin infusion (CSII).

Methods

Retrospective, observational, single centre study conducted on 69 adult patients evaluated for CSII. An analysis was made on patients who did not initiate CSII (n = 18) and patients who were treated with CSII (n = 51). Variables included: age, gender, duration of disease, indication for CSII, HbA1c, frequency of severe hypoglycaemia events, episodes of diabetic ketoacidosis, and pump discontinuation.

Results

The main reason for not initiating CSII was patient refusal (49%), followed by improving of glycaemic control (33%) after optimising with multiple daily injections (MDI) therapy. The most common CSII indications were: suboptimal glycaemic control (49%), and suboptimal glycaemic control with frequent non-severe hypoglycaemia (27.5%). Baseline HbA1c was 8.6 ± 1.5%, and there was a significant and sustained decrease of 1% over a 5 year period (P < .001), with this reduction being greater in patients with HbA1c > 8%. The use of CSII was stopped by 5 patients (10%) after 1 to 6 years.

Conclusion

In our clinical practice one in four patients evaluated for CSII did not initiate it. The switch from MDI to CSII was associated with a 1% reduction in HbA1c over 5 years, being greater in patients with poor glycaemic control.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信