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首页> 外文期刊>Diabetic medicine: A journal of the British Diabetic Association >Continuous subcutaneous insulin infusion is more effective than multiple daily insulin injections in preventing albumin excretion rate increase in Type 1 diabetic patients.
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Continuous subcutaneous insulin infusion is more effective than multiple daily insulin injections in preventing albumin excretion rate increase in Type 1 diabetic patients.

机译：在预防1型糖尿病患者中白蛋白排泄率增加方面，连续皮下胰岛素输注比每日多次胰岛素注射更有效。

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摘要

AIMS: To compare the effect of continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) on albumin excretion rate (AER) in Type 1 diabetic patients. METHODS: In a 3-year multicentre retrospective observational study, 110 Type 1 diabetic patients treated with CSII were compared with 110 patients treated with MDI matched at baseline for age, sex, diabetes duration and HbA(1c). At entry, 90 patients in each group had normal AER and 20 persistent microalbuminuria. AER, estimated glomerular filtration rate (eGFR), HbA(1c,) lipids and blood pressure were assessed. RESULTS: HbA(1c) was lower in the CSII than in the MDI group (8.1 +/- 0.9 vs. 8.4 +/- 1.3%; P < 0.005 after 3 years). Blood pressure and eGFR were similar during the study. AER [median (95% confidence interval)], similar at baseline [6.0 microg/min (9, 21) in the CSII group vs. 4.4 (8, 16) in the MDI group, NS] was significantly lower in the patients treated with CSII both at year 2 and at year 3 of follow-up [4.7 microg/min (6, 12) vs. 6.4 (13, 29), P < 0.002]. This difference was observed even when normo- and microalbuminuric patients were analysed separately. Nine patients progressed to microalbuminuria in the MDI group and only one in the CSII group. Nine patients regressed to normoalbuminuria in the CSII group, whereas only two regressed to normoalbuminuria in the MDI group. CONCLUSIONS: Despite a small benefit in terms of improved glycaemic control, CSII therapy may be useful in decreasing the progressive increase in AER in Type 1 diabetic patients.
机译：目的：比较连续皮下胰岛素输注（CSII）和每日多次胰岛素注射（MDI）对1型糖尿病患者白蛋白排泄率（AER）的影响。方法：在一项为期3年的多中心回顾性观察研究中，将110名接受CSII治疗的1型糖尿病患者与110名接受MDI治疗的基线，年龄，性别，糖尿病病程和HbA（1c）相匹配的患者进行了比较。入组时，每组90例AER正常，持续存在20例微量白蛋白尿。 AER，评估肾小球滤过率（eGFR），HbA（1c）脂质和血压。结果：CSII中的HbA（1c）低于MDI组（8.1 +/- 0.9对8.4 +/- 1.3％; 3年后P <0.005）。在研究期间，血压和eGFR相似。在治疗的患者中，AER [中位数（95％置信区间）]与基线相似[CSII组为6.0 microg / min（9，21），而MDI组为NS（4.4，8，16），NS]显着降低在随访的第2年和第3年接受CSII治疗[4.7 microg / min（6，12）vs. 6.4（13，29），P <0.002]。即使分别对正常白蛋白尿患者和微量白蛋白尿患者进行分析，也可以观察到这种差异。 MDI组有9名患者进展为微量白蛋白尿，CSII组只有1名患者进展为微量白蛋白尿。 CSII组中有9名患者退为正常白蛋白尿，而MDI组中只有2名患者为退回了正常白蛋白尿。结论：尽管改善血糖控制效果不佳，但CSII治疗可能有助于减少1型糖尿病患者AER的逐步升高。

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