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首页> 外文期刊>Pediatric diabetes. >Incidence of severe hypoglycemia and possible associated factors in pediatric patients with type 1 diabetes in the real‐life, post‐Diabetes Control and Complications Trial setting: A systematic review
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Incidence of severe hypoglycemia and possible associated factors in pediatric patients with type 1 diabetes in the real‐life, post‐Diabetes Control and Complications Trial setting: A systematic review

机译：严重低血糖发生的发病率和儿科患者在现实型糖尿病患者中可能的相关因素，糖尿病患者控制和并发症试验环境：系统审查

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Abstract Background/Objective In 1993, the Diabetes Control and Complications Trial (DCCT) found that intensive antihyperglycemic therapy was effective in the primary and secondary prevention of microvascular complications in patients with type 1 diabetes (T1D) but was associated with a 3‐fold greater rate of severe hypoglycemia (SH) than conventional therapy. The aim of this analysis was to determine whether, in the real‐world setting, the incidence of SH in pediatric patients with T1D has changed since 1993. Methods A systematic literature search of PubMed for prospective or retrospective observational studies (≥250 participants) on SH epidemiology or related topics in pediatric patients with T1D, published between October 1993 and June 2016, identified 35 articles (involving 55?000 participants). SH incidence data were analyzed in approximate 5‐year blocks: 1993‐2000, 2001‐2005, 2006‐2010, and 2011‐2016. Information on factors that might influence the incidence of SH was also collected. Results A trend for a marked reduction in the incidence of SH in the post‐DCCT setting (from 62.0 per 100 patient‐years to 1.21‐30 per 100 patient‐years) was apparent. Factors that could have influenced this temporal trend in SH incidence included the increased use of new types of, and methods of administering, insulin , in particular rapid‐acting insulin analogs and continuous subcutaneous insulin infusion. Conclusions SH in pediatric patients with T1D has declined in incidence since the DCCT but remains a common problem. The optimal use of new insulin therapies/regimens/technologies, improved education, and dedicated specialized management teams are needed to help reduce the risk of SH in this population.
机译：摘要背景/目标于1993年，糖尿病控制和并发症试验（DCCT）发现，强化抗血性治疗在1型糖尿病患者（T1D）中的微血管并发症中的初级和二次预防有效，但与3倍更大的微血管并发症严重低血糖（SH）的速率比常规治疗。该分析的目的是确定在真实世界中，自1993年以来，在T1D的儿科患者中SH的发病率发生变化。方法对预期或回顾性观测研究的PUBMED进行系统文献搜索（≥250名参与者） SH流行病学或与T1D患者的相关话题，1993年10月至2016年6月在2016年6月，确定了35篇文章（涉及55 000名参与者）。 SH发病率数据在大约5年段中分析：1993-2000,2001-2005,2006-2010和2011-2016。收集有关可能影响SH发病率的因素的信息。结果DCCT环境中SH发生率明显降低的趋势（从每100例患者 - 每100岁患者年为1.21-30岁，每100岁患者年份为1.21-30）是显而易见的。可能影响SH发病率的这种时间趋势的因素包括增加使用新型类型的使用和施用胰岛素，特别是快速作用胰岛素类似物和连续皮下胰岛素输注的方法。由于DCCT仍然存在常见问题，因此结论SH在儿科患者中有所下降，但仍然是一个常见的问题。新的胰岛素治疗/技术，改进教育和专业的专业管理团队的最佳用途是有助于降低这群人群的风险。

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