Predictive Low-Glucose Insulin Suspension Reduces Duration of Nocturnal Hypoglycemia in Children Without Increasing Ketosis.
Predictive Low-Glucose Insulin Suspension Reduces Duration of Nocturnal Hypoglycemia in Children Without Increasing Ketosis.
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DOI：
10.2337/dc14-3053
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发表时间：
2015-07
期刊：
影响因子：
16.2
通讯作者：
In Home Closed Loop Study Group
中科院分区：
文献类型：
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作者：
Buckingham BA;Raghinaru D;Cameron F;Bequette BW;Chase HP;Maahs DM;Slover R;Wadwa RP;Wilson DM;Ly T;Aye T;Hramiak I;Clarson C;Stein R;Gallego PH;Lum J;Sibayan J;Kollman C;Beck RW;In Home Closed Loop Study Group
夜间低血糖可导致癫痫发作，是严格控制血糖的主要障碍，特别是在患有1型糖尿病的幼儿中。我们进行了一项家庭随机试验，以评估基于连续血糖监测仪的夜间预测性低糖暂停(PLGS)系统的有效性和安全性。在两个年龄组的1型糖尿病儿童(11-14岁和4-10岁)中，对每个儿童进行了42晚的试验，其中每个晚上被随机分配到PLGS系统处于活动状态(干预夜)或不活动(对照夜)。主要结果是过夜的百分比时间和70 mg/dL。在11-14岁儿童(n=45)和4-10岁儿童(n=36)中，在70 mg/dl的中位时间减少了54%，从对照夜的10.1%减少到干预夜(P<；0.001)的4.6%，从6.2%减少到3.1%(P<；0.001)。两个年龄组的平均夜间血糖均低于干预前(分别为144vs.152±19 mg/dL[P<；0.001]和153.15±14vs.160±16mgdL[P=0.004])。11~14岁和4~10岁儿童晨间平均血糖分别为159±29vs176±28 mg/dL(P<0.001)和154±25vs.158±22 mg/dL(P=0.11)。在两个年龄组的晨血酮症中，干预组和对照组之间没有发现差异。在4-14岁的儿童中，使用夜间PLGS系统可以显著降低夜间低血糖，而不会增加清晨酮症的发生率，尽管夜间平均血糖略高。
Nocturnal hypoglycemia can cause seizures and is a major impediment to tight glycemic control, especially in young children with type 1 diabetes. We conducted an in-home randomized trial to assess the efficacy and safety of a continuous glucose monitor–based overnight predictive low-glucose suspend (PLGS) system. In two age-groups of children with type 1 diabetes (11–14 and 4–10 years of age), a 42-night trial for each child was conducted wherein each night was assigned randomly to either having the PLGS system active (intervention night) or inactive (control night). The primary outcome was percent time <70 mg/dL overnight. Median time at <70 mg/dL was reduced by 54% from 10.1% on control nights to 4.6% on intervention nights (P < 0.001) in 11–14-year-olds (n = 45) and by 50% from 6.2% to 3.1% (P < 0.001) in 4–10-year-olds (n = 36). Mean overnight glucose was lower on control versus intervention nights in both age-groups (144 ± 18 vs. 152 ± 19 mg/dL [P < 0.001] and 153 ± 14 vs. 160 ± 16 mg/dL [P = 0.004], respectively). Mean morning blood glucose was 159 ± 29 vs. 176 ± 28 mg/dL (P < 0.001) in the 11–14-year-olds and 154 ± 25 vs. 158 ± 22 mg/dL (P = 0.11) in the 4–10-year-olds, respectively. No differences were found between intervention and control in either age-group in morning blood ketosis. In 4–14-year-olds, use of a nocturnal PLGS system can substantially reduce overnight hypoglycemia without an increase in morning ketosis, although overnight mean glucose is slightly higher.
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影响因子：
16.2
作者：
Hovorka R;Elleri D;Thabit H;Allen JM;Leelarathna L;El-Khairi R;Kumareswaran K;Caldwell K;Calhoun P;Kollman C;Murphy HR;Acerini CL;Wilinska ME;Nodale M;Dunger DB
通讯作者：
Dunger DB
影响因子：
5.9
作者：
通讯作者：
--
影响因子：
16.2
作者：
Maahs, David M.;Calhoun, Peter;Beck, Roy W.
通讯作者：
Beck, Roy W.
影响因子：
16.2
作者：
Perantie, Dana C.;Wu, Jenny;Hershey, Tamara
通讯作者：
Hershey, Tamara
影响因子：
7.7
作者：
Marzelli MJ;Mazaika PK;Barnea-Goraly N;Hershey T;Tsalikian E;Tamborlane W;Mauras N;White NH;Buckingham B;Beck RW;Ruedy KJ;Kollman C;Cheng P;Reiss AL;Diabetes Research in Children Network (DirecNet)
通讯作者：
Diabetes Research in Children Network (DirecNet)