Daily insulin requirement of children and adolescents with type 1 diabetes: effect of age, gender, body mass index and mode of therapy
Daily insulin requirement of children and adolescents with type 1 diabetes: effect of age, gender, body mass index and mode of therapy
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DOI：
10.1530/eje-07-0904
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发表时间：
2008-04-01
影响因子：
5.8
通讯作者：
Holl, Reinhard W.
中科院分区：
文献类型：
--
作者：
Wiegand, Susanna;Raile, Klemens;Holl, Reinhard W.
设计图：本研究的目的是为儿童和青少年1型糖尿病（T2 DM）患者生成胰岛素剂量（ID）表，以便有机会评估与年龄和性别相关的这一重要参数。记录了22177例糖尿病患者的每日ID/体重（ID/kg（3-25岁，病程超过2年，48%，女性）和ID表ID-Perc）进行统计学创建。比较男性与女性、多次胰岛素注射治疗（MIT）与连续皮下注射治疗（S.C.）的ID-Perc。胰岛素输注（CSII）。以ID/kg、体重、年龄、性别和胰岛素给药方案为变量，对DM 1第3年的ID进行多变量回归分析。第50个ID-Perc（P50）在0.67 IU/kg（3岁）、0.93 IU/kg（13岁）和0.70 IU/kg（23岁）之间变化，从幼儿期到青春期增加，并向成年期下降。雌性动物在12岁时（0.94 IU/kg）和雄性动物在14岁时（0.92 IU/kg）发现最高P50 11）。使用ICT时，ID显著高于CSII（P50：13岁时0.94 IU/kg vs 0.79 IU/kg）。多元回归分析显示，ID与年龄、性别、胰岛素给药方式有显著相关性（P > 0.001）。结论：儿童期不同时期ID-Perc存在显著差异，且受性别、体重、胰岛素给药方式的影响。因此，所提供的数据1）提供了解释儿童和青少年胰岛素抵抗的个体ID的证据，2）更具体地确定了胰岛素需求异常高（胰岛素抵抗和不依从）或低（MODY和持续缓解）的儿童。
Design: The purpose of this study was to generate insulin dose (ID) percentiles for children and adolescents with type 1 diabetes mellitus (DMI) having the opportunity to assess this important parameter in relation to age and sex.Methods: Daily IDs per weight (ID/kg) were recorded in 22 177 patients with DMI (3-25 years of age, DMI duration of more than 2 years, 48%, female) and ID percentiles ID-Perc) were created statistically. The ID-Perc were compared between male and female, and between multiple insulin injection therapy (MIT) and continuous s.c. insulin infusion (CSII). A multivariate regression analysis was performed for ID in the third year of DM1 with ID/kg, body weight, age, gender, and insulin delivery regimen as variables.Results: The 50th ID-Perc (P50) varied among 0.67 IU/kg (age 3 years), 0.93 IU/kg (13 years), and 0.70 IU/kg (23 years) increasing from early childhood to adolescence and decreasing toward adulthood. Highest P50 11) was found at 12 years in females (0.94 IU/kg) and at 14 years in males (0.92 IU/kg). Using ICT, the ID was significantly higher compared with CSII (P50: 0.94 IU/kg versus 0.79 IU/kg at 13 years). In multivariate regression analysis, ID was significantly (P > 0.001) associated with age, gender, and insulin delivery regime.Conclusion: The ID-Perc were significantly different during various periods of childhood and were influenced by gender, body weight, and insulin injection regimes. Therefore, the presented data 1) provide evidence to interpret individual ID in children and adolescents with DMI and 2) more specifically identify children with unusually high (insulin resistance and non-compliance) or low (MODY and persistent remission) insulin requirement.