Use of the insulin pump in treat cystic fibrosis related diabetes
Use of the insulin pump in treat cystic fibrosis related diabetes
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DOI：
10.1016/j.jcf.2008.12.001
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发表时间：
2009-05-01
影响因子：
5.2
通讯作者：
Rosenblatt, Randall
中科院分区：
文献类型：
--
作者：
Hardin, Dana S.;Rice, Julie;Rosenblatt, Randall
目的：研究胰岛素泵持续皮下胰岛素输注(CSII)治疗囊性纤维化相关性糖尿病(CFRD)的疗效和耐受性。我们还验证了CSII可以改善体重、血糖控制、瘦体重、全身蛋白代谢、肝脏葡萄糖生成(HGP)的假设。方法：我们招募了9例确诊为糖尿病的CF患者，并对他们进行为期6个月的胰岛素泵治疗。每个受试者在使用泵之前和使用期间都记录了每日的血糖。在放置泵前和6个月结束时，每个患者都接受了以下测量：1)使用稳定同位素[L-C-13]亮氨酸测定全身蛋白质周转；2)双能X线扫描测量瘦体重；3)人体测量亮氨酸；4)测量血红蛋白Ale。结果：患者的空腹和餐后血糖水平、体重、糖化血红蛋白和瘦体重均有显著改善。以亮氨酸出现率衡量的蛋白质分解代谢显著降低，肝脏葡萄糖产量也显著降低。在研究过程中没有患者出现低血糖。结论：本研究证明CSII对CFRD的治疗是安全有效的，而且代谢方面也有好处。(C)2008年，由爱思唯尔公司代表欧洲囊性纤维化学会出版。
Objectives: This study was conducted to determine efficacy and tolerability of the continued subcutaneous insulin infusion (CSII) via an insulin pump for treatment of Cystic Fibrosis Related Diabetes (CFRD). We also tested the hypothesis that CSII would improve body weight, blood sugar control, lean body mass, whole body protein tumover, hepatic glucose production (HGP).Methods: We recruited 9 CF patients with established diabetes and placed them on insulin pump therapy for six months. Each subject kept daily blood sugar records before and during pump use. Prior to the pump placement and at the end of six months, each patient underwent the following measurements: 1) whole body protein turnover using the stable isotope [l-C-13] leucine; 2) DEXA scan for measurement of lean body mass; leucine, 3) anthropometric measurements-, 4) Hemoglobin Ale. Patient data was compared to baseline data and the mean change from baseline was analyzed.Results: There was significant improvement in both fasting and post-prandial blood glucose levels, body weight, HbAlC, and lean mass. Protein catabolism as measured by leucine rate of appearance was significantly lower, as was hepatic glucose production. No patient developed hypoglycemia during the study.Conclusions: This study demonstrates that CSII is safe and effective for treatment of CFRD and that metabolic benefits are also present. (C) 2008 Published by Elsevier B.V. on behalf of European Cystic Fibrosis Society.