Transition from multiple daily injections to continuous subcutaneous insulin infusion in type 1 diabetes mellitus.
Transition from multiple daily injections to continuous subcutaneous insulin infusion in type 1 diabetes mellitus.
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DOI：
10.1067/mpd.2002.120509
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发表时间：
2002-02
期刊：
影响因子：
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通讯作者：
S. Conrad;Maureen T. Mcgrath;S. Gitelman
中科院分区：
文献类型：
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作者：
S. Conrad;Maureen T. Mcgrath;S. Gitelman
目的回顾我们在儿童和青少年1型糖尿病患者从每日多次注射胰岛素转为持续皮下胰岛素输注（CSII）期间的胰岛素剂量经验。研究设计：对1998年1月至2000年4月开始CSII的65名儿童的图表进行了审查。从泵前访视以及接受泵治疗后的第一次（1 - 2个月）和第二次（3 - 6个月）访视收集有关胰岛素剂量和血红蛋白A1 c水平的数据。结果青春期患者CSII胰岛素总剂量减少;青春期前患者变化不大（-18 +/- 3.5% vs -1.7 +/-5%，P = 0.01）。CSII时，青春期前和青春期患者的基础胰岛素剂量均占总胰岛素的40%至45%。青春期前患者的最大基础心率发生在9 PM至12 AM，青春期患者的最大基础心率发生在3 AM至9 AM和9 PM至12 AM。结论：成人CSII给药指南不一定适用于儿童。青春期患者需要减少胰岛素日总剂量，但青春期前患者可保持不变。基础输注率占每日胰岛素总剂量的40%至45%，青春期前儿童的最大基础输注率时间可能发生在深夜。
OBJECTIVE To review our experience with insulin dosing during the conversion from multiple daily injections to continuous subcutaneous insulin infusion (CSII) for children and adolescents with type 1 diabetes mellitus. STUDY DESIGN The charts of 65 children who started CSII from January 1998 to April 2000 were reviewed. Data regarding insulin dose and hemoglobin A1c levels were collected from the prepump visit and first (at 1 to 2 months) and second (at 3 to 6 months) visits after being placed on pump therapy. RESULTS Pubertal patients had a decrease in total insulin dose taking CSII; prepubertal patients had little change (-18 +/- 3.5% vs -1.7 +/- 5%, P =.01). On CSII, the basal insulin dose comprised 40% to 45% of total insulin in both prepubertal and pubertal patients. Maximal basal rate in prepubertal patients occurred from 9 PM to 12 AM and in pubertal patients from 3 AM to 9 AM and from 9 PM to 12 AM. CONCLUSION Guidelines established for CSII dosing in adults do not necessarily apply to children. The total daily insulin dose needs to be decreased in pubertal patients but may remain unchanged in prepubertal patients. The basal rate comprises 40% to 45% of the total daily insulin dose, and the timing of maximum basal rates is likely to occur in the late evening hours in prepubertal children.