Adherence to Insulin Pump Behaviors in Young Children With Type 1 Diabetes Mellitus.
Adherence to Insulin Pump Behaviors in Young Children With Type 1 Diabetes Mellitus.
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DOI：
10.1177/1932296816658901
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发表时间：
2017-01-01
影响因子：
5
通讯作者：
Clements, Mark A
中科院分区：
文献类型：
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作者：
Patton, Susana R;Driscoll, Kimberly A;Clements, Mark A
背景：幼儿的父母负责每日1型糖尿病（T1DM）护理，包括胰岛素注射。为了优化胰岛素泵管理，父母应该将血糖结果（SMBG）和碳水化合物估计（如果要消耗食物）输入到孩子泵中的剂量顾问中，以帮助提供推荐的胰岛素剂量。以前，青少年的泵依从性行为被描述；我们在一组幼儿中描述了这些行为。方法：获得116例儿童连续14-30天的泵数据。评估对基本泵依从行为的依从性（例如，SMBG、碳水化合物进入和胰岛素使用）以及对3个Wizard/Bolus Advisor步骤的依从性：SMBG-碳水化合物进入-胰岛素递送。结果：家长完成SMBG≥4次的天数占99%，胰岛素≥3次的天数占95%，碳水化合物≥3次的天数占93%，但纠正高血糖（≥250 mg/dl或13.9 mmol/l）的时间仅占63%。43%的家长在30分钟内完成了向导/药丸顾问步骤（SMBG，碳水化合物输入，胰岛素药丸）。儿童的平均每日葡萄糖与SMBG≥4和碳水化合物≥3的天数百分比以及完成所有Wizard/Bolus Advisor步骤的天数百分比呈负相关。结论：幼儿的父母坚持单独的泵行为，但在坚持Wizard/Bolus Advisor步骤方面表现出一些差异。家长对纠正高血糖建议的依从性较低。像青少年一样，针对幼儿的泵行为可能有优化血糖控制的潜力。
BACKGROUND: Parents of young children are responsible for daily type 1 diabetes (T1DM) cares including insulin bolusing. For optimal insulin pump management, parents should enter a blood glucose result (SMBG) and a carbohydrate estimate (if food will be consumed) into the bolus advisor in their child's pump to assist in delivering the recommended insulin bolus. Previously, pump adherence behaviors were described in adolescents; we describe these behaviors in a sample of young children.METHODS: Pump data covering between 14-30 consecutive days were obtained for 116 children. Assessed adherence to essential pump adherence behaviors (eg, SMBG, carbohydrate entry, and insulin use) and adherence to 3 Wizard/Bolus Advisor steps: SMBG-carbohydrate entry-insulin bolus delivered.RESULTS: Parents completed SMBG ≥4 times on 99% of days, bolused insulin ≥3 times on 95% of days, and entered carbohydrates ≥3 times on 93% of days, but they corrected for hyperglycemia (≥250 mg/dl or 13.9 mmol/l) only 63% of the time. Parents completed Wizard/Bolus Advisor steps (SMBG, carbohydrate entry, insulin bolus) within 30 minutes for 43% of boluses. Inverse correlations were found between children's mean daily glucose and the percentage of days with ≥4 SMBG and ≥3 carbohydrate entries as well as the percentage of boluses where all Wizard/Bolus Advisor steps were completed.CONCLUSIONS: Parents of young children adhered to individual pump behaviors, but showed some variability in their adherence to Wizard/Bolus Advisor steps. Parents showed low adherence to recommendations to correct for hyperglycemia. Like adolescents, targeting pump behaviors in young children may have the potential to optimize glycemic control.