Impact of pramlintide on glucose fluctuations and postprandial glucose, glucagon, and triglyceride excursions among patients with type 1 diabetes intensively treated with insulin pumps
Impact of pramlintide on glucose fluctuations and postprandial glucose, glucagon, and triglyceride excursions among patients with type 1 diabetes intensively treated with insulin pumps
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DOI：
10.2337/diacare.26.1.1
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发表时间：
2003-01-01
期刊：
影响因子：
16.2
通讯作者：
Henry, RR
中科院分区：
文献类型：
--
作者：
Levetan, C;Want, LL;Henry, RR
目的-评估普兰林肽（β细胞激素胰淀素的类似物）连续治疗对连续皮下胰岛素输注（CSII）强化治疗的I型糖尿病患者24小时血糖波动和餐后血糖、胰高血糖素和甘油三酯波动的影响。18例1型糖尿病患者（其中16例可进行评估）（年龄44 ± 11岁，HbA（1c）8.2 ± 1.3% [平均SD]）在餐时注射30 μ g普兰林肽，每日3次。在原有CSII方案（16例赖脯胰岛素，2例常规胰岛素）的基础上增加4周。在前3天内，餐时胰岛素推注量至少减少10%，此后根据临床判断重新调整。第0周（基线），4（治疗中）和6（停止治疗2周），使用连续葡萄糖监测系统（CGMS）测量24小时间质葡萄糖浓度，并测量餐后血浆葡萄糖、胰高血糖素和甘油三酯浓度以响应标准化测试餐。59%的CGMS测量值>140 mg/dl，13%
OBJECTIVE - To assess the effects of adjunctive treatment with pramlintide, an analog of the beta-cell hormone amylin, on 24-h glucose fluctuations and postprandial glucose, glucagon, and triglyceride excursions in patients with type I diabetes intensively treated with Continuous subcutaneous insulin infusion (CSII).RESEARCH DESIGN AND METHODS - in this study, 18 patients (16 of whom could be evaluated) with type 1 diabetes (age 44 +/- 11 years, HbA(1c) 8.2 +/- 1.3% [mean SD]) were given mealtime injections of 30 mug pramlintide t.i.d. for 4 weeks in addition to their preexisting CSII regimen (16 lispro, 2 regular insulin). Mealtime insulin boluses were reduced by a minimum of 10% during the first 3 days, and re-adjusted thereafter based on clinical judgment. At weeks 0 (baseline), 4 (on treatment), and 6 (2 weeks off treatment), 24-h interstitial glucose concentrations were measured using a continuous glucose monitoring system (CGMS), and postprandial plasma glucose, glucagon, and triglyceride concentrations were measured in response to a standardized test meal.RESULTS - At baseline, patients had excessive 24-h glucose fluctuations, with 59% of the CGMS measurements >140 mg/dl, 13%