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首页> 外文期刊>Diabetes technology & therapeutics >Continuous Subcutaneous Insulin Infusion in Neonates and Infants Below 1 Year: Analysis of Initial Bolus and Basal Rate Based on the Experiences from the German Working Group for Pediatric Pump Treatment
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Continuous Subcutaneous Insulin Infusion in Neonates and Infants Below 1 Year: Analysis of Initial Bolus and Basal Rate Based on the Experiences from the German Working Group for Pediatric Pump Treatment

机译：新生儿和1岁以下婴儿的连续皮下胰岛素输注：基于德国小儿泵治疗工作组的经验对初始小剂量和基础率进行分析

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Background: Diabetes mellitus is rare in young infants and neonates. Continuous subcutaneous insulin infusion (CSII) is used most frequently for insulin treatment in this age group. However, the individual doctor's experience is scarce because of the low prevalence of diabetes in this age. For this study patients treated with CSII with an age below 1 year were selected from the German/Austrian DPV (Diabetes-Patienten-Verlaufsdokumentation) database, and basal rate and bolus calculation were described. Materials and Methods: For all patients less than 1 year of age, basal rate and mealtime boluses were compared among infants with type 1 diabetes mellitus (T1DM), infants with neonatal diabetes mellitus (NDM), and infants with antibody status unknown diabetes mellitus (AUDM). Results: Fifty-eight patients with T1DM, 67 neonates with NDM, and 43 infants with early diabetes development after 6 months and negative -cell antibodies (AUDM) could be analyzed. T1DM patients at onset required a median total insulin amount of 0.83IU/kg of body weight, whereas NDM patients required 0.74IU/kg of body weight (P=0.63). Basal insulin requirement however, was different between the two groups (0.56IU/kg of body weight in NDM vs. 0.43IU/kg in T1DM) (P=0.036). The percentage basal profile of NDM and T1DM patients was quite similar to children at the age of 1-5 years. The proportion of prandial insulin at onset was significantly different (32% in NDM vs. 53% in T1DM) (P<0.00001). AUDM patients showed almost similar data to T1DM patients. The pattern of mealtime bolus insulin was not different among the groups. Conclusions: The presented data can be used as an initial guide value to start CSII treatment in neonates and infants. To be on the safe side we recommend the lower quartile for the dosage as the starting value in nonketotic patients.
机译：背景：糖尿病在幼儿和新生儿中很少见。在该年龄组中，连续皮下胰岛素输注（CSII）最常用于胰岛素治疗。但是，由于该年龄段糖尿病的患病率较低，因此缺乏个别医生的经验。对于该研究，从德国/奥地利DPV（糖尿病-患者-患者-Verlaufsdokumentation）数据库中选择了1岁以下的CSII治疗的患者，并描述了基础率和推注计算。材料和方法：对于所有1岁以下的患者，比较了1型糖尿病（T1DM）婴儿，新生儿糖尿病（NDM）婴儿和抗体状态未知的糖尿病婴儿的基础率和进餐时大剂量（ AUDM）。结果：可以分析58例T1DM患者，67例NDM新生儿和43例在6个月后患有早期糖尿病且阴性细胞抗体（AUDM）的婴儿。 T1DM患者起病时的总胰岛素中位数为0.83IU / kg体重，而NDM患者则为0.74IU / kg体重（P = 0.63）。两组的基础胰岛素需求量不同（NDM组为0.56IU / kg体重，T1DM组为0.43IU / kg体重）（P = 0.036）。 NDM和T1DM患者的基础基础百分比与1-5岁的儿童非常相似。餐前胰岛素的比例显着不同（NDM组为32％，T1DM组为53％）（P <0.00001）。 AUDM患者显示的数据几乎与T1DM患者相似。进餐时推注胰岛素的模式在各组之间没有差异。结论：所提供的数据可作为开始对婴儿进行CSII治疗的初始指导值。为了安全起见，我们建议剂量较低的四分位数作为非酮症患者的起始值。

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