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首页> 外文期刊>Diabetes technology & therapeutics >Feasibility of continuous subcutaneous insulin infusion and daily supplemental insulin glargine injection in children with type 1 diabetes.
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Feasibility of continuous subcutaneous insulin infusion and daily supplemental insulin glargine injection in children with type 1 diabetes.

机译：在1型糖尿病患儿中连续皮下注射胰岛素和每日补充甘精胰岛素注射液的可行性。

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BACKGROUND: Continuous subcutaneous insulin infusion (CSII) is an effective method of insulin substitution with increased risk of hypoglycemia and diabetic ketoacidosis (DKA) in rare situations. The lack of subcutaneous long-acting insulin and short half-life of serum insulin increases the risk of ketosis and DKA following CSII failure. We evaluated the metabolic effects of CSII with and without daily supplemental long-acting insulin glargine in a group of young children switched to CSII from multiple daily insulin (premeal aspart + glargine) to either CSII plus daily glargine (CSII + G) or CSII therapy. METHODS: From retrospective clinic data, self-monitored blood glucose (SMBG), hemoglobin A1c (HbA(1c)), hypoglycemic episodes, and body mass index (BMI) were obtained from 12 patients (five girls, seven boys; 7.7 +/- 1.8 years) on CSII + G and 12 age- and gender-matched patients (five girls, seven boys; 7.7 +/- 2.1 years) on CSII with similar baseline HbA(1c) and BMI were reviewed over a 1.0-year period. RESULTS: The insulin glargine dose in the CSII + G group was 30.6 +/- 12.4% (range, 13.9-53.3%) of daily basal insulin dose. Both groups had similar total daily insulin and bolus:basal insulin at baseline and at 1.0 year. Glycemic control improved in the CSII + G (SMBG, 195.5 +/- 47.3 vs. 156.8 +/- 36.8 mg/dL, P < 0.05; HbA(1c), 8.1 +/- 0.9% vs. 7.4 +/- 0.4%, P < 0.02) and CSII (SMBG, 198.7 +/- 45.7 vs. 161.4 +/- 30.9 mg/dL, P < 0.05; HbA(1c), 8.2 +/- 0.4% vs. 7.7 +/- 0.5%, P < 0.01) groups without significant changes in hypoglycemic episodes and BMI. There were no DKA episodes despite three emergency room visits for hyperglycemia and ketosis due to catheter dislodgement only in the CSII group. CONCLUSIONS: CSII therapy with or without daily insulin glargine improved glycemic control without changes in the rate of hypoglycemia and DKA, suggesting that this treatment regimen is feasible and may also prevent development of hyperglycemia and ketosis or even DKA.
机译：背景：连续皮下注射胰岛素（CSII）是一种有效的胰岛素替代方法，在极少数情况下会降低低血糖和糖尿病性酮症酸中毒（DKA）的风险。缺乏皮下长效胰岛素和血清胰岛素半衰期短会增加CSII失败后发生酮症和DKA的风险。我们评估了在有和没有每日补充长效胰岛素甘精胰岛素的情况下，一组CSII从每天多次胰岛素（餐前天冬氨酸+甘精胰岛素）改为CSII加上每日甘精胰岛素（CSII + G）或CSII治疗的儿童的代谢作用。方法：从回顾性临床数据中，从12名患者（5名女孩，7名男孩; 7.7 + /个）中获得了自我监测的血糖（SMBG），血红蛋白A1c（HbA（1c）），降血糖发作和体重指数（BMI）。 -CSII + G为1.8岁），以及在1.0年内对基线IIb HbA（1c）和BMI为相似的CSII的12名年龄和性别匹配的患者（5名女孩，7名男孩; 7.7 +/- 2.1岁）进行了回顾。 。结果：CSII + G组的甘精胰岛素剂量为每日基础胰岛素剂量的30.6 +/- 12.4％（范围为13.9-53.3％）。两组在基线和1.0年时的每日总胰岛素和推注：基础胰岛素相似。 CSII + G的血糖控制得到改善（SMBG，195.5 +/- 47.3 vs. 156.8 +/- 36.8 mg / dL，P <0.05; HbA（1c），8.1 +/- 0.9％vs. 7.4 +/- 0.4％ ，P <0.02）和CSII（SMBG，198.7 +/- 45.7 vs. 161.4 +/- 30.9 mg / dL，P <0.05; HbA（1c），8.2 +/- 0.4％vs. 7.7 +/- 0.5％， P <0.01）组的降血糖发作和BMI没有明显变化。尽管仅在CSII组中因导管移位而进行了3次因血糖过高和酮病而急诊的门诊，但仍未发生DKA发作。结论：CSII疗法联合或不联合每日服用甘精胰岛素均可改善血糖控制，而不会降低低血糖症和DKA的发生率，这表明该治疗方案是可行的，并且还可预防高血糖症和酮症甚至DKA的发生。

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