Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.
Ketone production in children with type 1 diabetes, ages 4-14 years, with and without nocturnal insulin pump suspension.
复制标题
4-14 岁 1 型糖尿病儿童在有或没有夜间胰岛素泵暂停的情况下的酮产生情况。
DOI：
10.1111/pedi.12410
复制
发表时间：
2017
影响因子：
3.4
通讯作者：
InHomeClosedLoopStudyGroup
中科院分区：
文献类型：
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作者：
Wadwa,RPaul;Chase,HPeter;Raghinaru,Dan;Buckingham,BruceA;Hramiak,Irene;Maahs,DavidM;Messer,Laurel;Ly,Trang;Aye,Tandy;Clinton,Paula;Kollman,Craig;Beck,RoyW;Lum,John;InHomeClosedLoopStudyGroup
目的比较4-14岁的1型糖尿病患者在夜间使用自动化低葡萄糖胰岛素混悬液系统或在对照夜间不使用该系统后，根据年龄不同，晨血酮水平升高的频率。分别在1155和2345个夜晚后使用Precision Xtra血酮仪评估早晨血酮水平的升高。重复测量logistic回归模型用于比较控制夜间后血酮水平升高的年龄组（系统未激活）和干预后的夜间胰岛素暂停和不暂停。4-9岁儿童580个对照夜中有10%的人出现血肌酐（≥ 0.6mmol/L），而10-14岁奥尔兹1162个对照夜中有2%的人出现血肌酐（≥ 0.6mmol/L）（P< 0.001）。同样，在较年轻的年龄组中，干预夜后的频率更高（575个夜晚中的13%对1183个夜晚中的2%，P< 0.001）。较长的泵暂停时间导致较年轻年龄组中早晨血酮升高的百分比较高（P= 0.002），但老年组中则不然（P= 0.63）。早晨酮水平升高的存在没有进展酮症酸中毒在任何subject.ConclusionsElevated早晨血酮是更常见的1型糖尿病与或不与夜间胰岛素暂停年幼的儿童。护理人员需要了解与各种临床情况相关的低龄儿童生酮的差异。
ObjectiveTo compare the frequency of elevated morning blood ketone levels according to age in 4–14 year olds with type 1 diabetes following overnight use of an automated low glucose insulin suspension system, or following control nights when the system was not used.Research design and methodsFor 28 children ages 4–9 years and 54 youth ages 10–14 years, elevation of morning blood ketone levels was assessed using the Precision Xtra Ketone meter following 1155 and 2345 nights, respectively. Repeated measures logistic regression models were used to compare age groups for blood ketone level elevation following control nights (system not activated) and following intervention nights with and without insulin suspension.ResultsElevated morning blood ketones (≥0.6 mmol/L) were present following 10% of 580 control nights in the 4–9 year olds compared with 2% of 1162 control nights in 10–14 year olds (P< 0.001). Likewise, the frequency was greater following intervention nights in the younger age group (13% of 575 nights vs 2% of 1183 nights,P< 0.001). A longer duration of pump suspension resulted in a higher percentage of mornings with elevated blood ketones in the younger age group (P= 0.002), but not in the older age group (P= 0.63). The presence of elevated morning ketone levels did not progress to ketoacidosis in any subject.ConclusionsElevated morning blood ketones are more common in younger children with type 1 diabetes with or without nocturnal insulin suspension. Care providers need to be aware of the differences in ketogenesis in younger age children relative to various clinical situations.