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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care.
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Continuous subcutaneous insulin infusion therapy for children and adolescents: an option for routine diabetes care.

机译：儿童和青少年的连续皮下胰岛素输注疗法：常规糖尿病护理的一种选择。

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OBJECTIVE: The purpose of this study was to determine the feasibility of continuous subcutaneous insulin infusion (CSII) (insulin pump) therapy in routine pediatric diabetes care by comparing the HbA(1c), body mass index (BMI), and hypoglycemic episodes before and after initiation of CSII therapy. RESEARCH DESIGN AND METHODS: Data from 56 patients (7-23 years old) were collected during regularly scheduled visits at a frequency similar to non-CSII patients. RESULTS: The data were analyzed for the entire cohort and 3 subgroups (decreased, stable, or increased HbA(1c)) stratified according to a >/=0.5% change in HbA(1c). The total cohort demonstrated a decrease in HbA(1c) from 8.5% to 8.3%. The decreased cohort (39.4% of the total cohort) demonstrated a significant decrease in HbA(1c) from 8.6% to 7.6%. The mean HbA(1c) of the stable cohort (41.0%) was 8.7%. The increased cohort (19.6%) had an increase in HbA(1c) from 7.8% to 8.8%. Thirty-six patients (64.3%) maintained or achieved a HbA(1c) <8.0% or achieved a HbA(1c) at least 1% lower than their pre-CSII level. Of concern, 6 patients (10.7%) demonstrated a clinically significant increase in HbA(1c) from 8.3% to 9.6%. For the entire cohort, the rate of severe hypoglycemia before and on CSII therapy was 12.3 and 9.5 events per 100 patient-years, respectively. A statistically significant proportion of patients reported a decrease in seizure frequency versus an increase (17.9% vs 1.8%) as well as a decrease in overall hypoglycemic frequency versus an increase (41.1% vs 17.9%). There was not a clinically significant increase in BMI, even in the decreased HbA(1c) cohort. CONCLUSIONS: CSII therapy is an appropriate option for some children in routine pediatric diabetes care. It can effectively decrease the HbA(1c) and reduce hypoglycemic episodes, without producing an abnormal increase in BMI.
机译：目的：本研究的目的是通过比较之前和之后的H​​bA（1c），体重指数（BMI）和降血糖发作情况，确定在常规小儿糖尿病护理中进行连续皮下胰岛素输注（CSII）（胰岛素泵）治疗的可行性。开始CSII治疗后。研究设计和方法：在定期计划的就诊期间以与非CSII患者相似的频率收集了来自56位患者（7-23岁）的数据。结果：对整个队列和3个亚组（HbA（1c）减少，稳定或增加）的数据进行了分析，并根据HbA（1c）的变化≥0.5％进行了分层。总队列显示HbA（1c）从8.5％降至8.3％。下降的队列（占总队列的39.4％）表明HbA（1c）从8.6％显着下降到7.6％。稳定队列的平均HbA（1c）（41.0％）为8.7％。队列增加（19.6％）的HbA（1c）从7.8％增加到8.8％。三十六名患者（64.3％）维持或达到HbA（1c）<8.0％或达到HbA（1c）比其CSII前水平低至少1％。值得关注的是，有6名患者（10.7％）的HbA（1c）临床上显着增加，从8.3％增加到9.6％。对于整个队列，CSII治疗前后的严重低血糖发生率分别为每100个患者年12.3和9.5个事件。统计学上显着比例的患者报告癫痫发作频率相对于增加（17.9％比1.8％）减少，总的降血糖频率相对增加（41.1％对17.9％）。即使降低HbA（1c）队列，BMI也没有临床上的显着增加。结论：CSII治疗是一些常规儿科糖尿病治疗儿童的适当选择。它可以有效降低HbA（1c）并降低降血糖发作，而不会导致BMI异常升高。

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