Closed-loop insulin therapy improves glycemic control in children aged <7 years: a randomized controlled trial.
Closed-loop insulin therapy improves glycemic control in children aged <7 years: a randomized controlled trial.
复制标题
DOI：
10.2337/dc12-1079
复制
发表时间：
2013-02
期刊：
影响因子：
16.2
通讯作者：
Steil GM
中科院分区：
文献类型：
--
作者：
Dauber A;Corcia L;Safer J;Agus MS;Einis S;Steil GM
评估闭环治疗改善7岁以下儿童夜间血糖控制和餐时血糖反应的可能性。这是一项在住院临床研究中心进行的比较闭环与标准开环胰岛素泵治疗的随机对照交叉试验。研究了10例<7 years with type 1 diabetes for >接受胰岛素泵治疗的6个月大受试者。从10：00 p.m.至12：00 p.m.连续2天比较闭环治疗和标准开环治疗。主要结局是夜间（10：00 p.m.-8：00 a.m.）血糖时间在范围内（110-200 mg/dL）。次要结果包括餐后血糖峰值水平、低血糖发生率、高血糖程度和午餐前血糖水平。闭环治疗与开环治疗相比，目标范围内的平均夜间时间有增加的趋势，但未达到统计学显著性（5.3 vs 3.2 h，P = 0.12）。餐后血糖峰值或低血糖发作次数无差异。闭环治疗在>300 mg/dL过夜的时间（0.18 vs. 1.3 h，P = 0.035）和葡萄糖>200 mg/dL的曲线下总面积（P = 0.049）方面有显著改善。闭环治疗使午餐前血糖更接近目标（189 vs.开环治疗273 mg/dL，P = 0.009）。闭环胰岛素输注可降低夜间高血糖的严重程度，而不会增加低血糖的发生率。该疗法能够更好地在下一餐之前重建目标葡萄糖水平。患有1型糖尿病的年幼儿童可能会从闭环治疗中获益匪浅。
To assess the possibility of improving nocturnal glycemic control as well as meal glycemic response using closed-loop therapy in children aged <7 years. This was a randomized controlled crossover trial comparing closed-loop with standard open-loop insulin pump therapy performed in an inpatient clinical research center. Ten subjects aged <7 years with type 1 diabetes for >6 months treated with insulin pump therapy were studied. Closed-loop therapy and standard open-loop therapy were compared from 10:00 p.m. to 12:00 p.m. on 2 consecutive days. The primary outcome was plasma glucose time in range (110–200 mg/dL) during the night (10:00 p.m.–8:00 a.m.). Secondary outcomes included peak postprandial glucose levels, incidence of hypoglycemia, degree of hyperglycemia, and prelunch glucose levels. A trend toward a higher mean nocturnal time within target range was noted for closed- versus open-loop therapy, although not reaching statistical significance (5.3 vs. 3.2 h, P = 0.12). There was no difference in peak postprandial glucose or number of episodes of hypoglycemia. There was significant improvement in time spent >300 mg/dL overnight with closed-loop therapy (0.18 vs. 1.3 h, P = 0.035) and the total area under the curve of glucose >200 mg/dL (P = 0.049). Closed-loop therapy returned prelunch blood glucose closer to target (189 vs. 273 mg/dL on open loop, P = 0.009). Closed-loop insulin delivery decreases the severity of overnight hyperglycemia without increasing the incidence of hypoglycemia. The therapy is better able to reestablish target glucose levels in advance of a subsequent meal. Younger children with type 1 diabetes may reap significant benefits from closed-loop therapy.
登录
查看更多内容
影响因子：
16.2
作者：
Castle JR;Engle JM;El Youssef J;Massoud RG;Yuen KC;Kagan R;Ward WK
通讯作者：
Ward WK
影响因子：
5.4
作者：
Gandrud, Laura M.;Xing, Dongyuan;Buckingham, Bruce A.
通讯作者：
Buckingham, Bruce A.
影响因子：
16.2
作者：
Swan, Karena L.;Dziura, James D.;Weinzimer, Stuart A.
通讯作者：
Weinzimer, Stuart A.
影响因子：
7.7
作者：
Steil, Garry M.;Rebrin, Kerstin;Saad, Mohammed F.
通讯作者：
Saad, Mohammed F.
影响因子：
16.2
作者：
Weinzimer, Stuart A.;Steil, Garry M.;Tamborlane, Williani V.
通讯作者：
Tamborlane, Williani V.