Use of an Ultrarapid Acting Insulin Analog with Control-IQ: A Case Report.
Use of an Ultrarapid Acting Insulin Analog with Control-IQ: A Case Report.
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使用超速效胰岛素类似物与 Control-IQ：病例报告。
DOI：
10.1089/dia.2022.0192
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发表时间：
2022
影响因子：
5.4
通讯作者：
Kovatchev,BorisP
中科院分区：
文献类型：
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作者：
Schoelwer,MelissaJ;DeBoer,MarkD;Breton,MarcD;Kovatchev,BorisP
尊敬的编辑，即使使用自动胰岛素输送 (AID) 系统等新技术，餐后血糖控制对于 1 型糖尿病 (T1D) 患者来说仍然具有挑战性。较新的胰岛素配方旨在通过使用加速胰岛素吸收的赋形剂来减少餐后血糖波动。研究发现，使用每日多次注射1和连续胰岛素输注，超快速赖脯胰岛素 (URLi) 在控制成人糖尿病患者的餐后血糖方面优于传统类似物。 2 目前，已经发表了几份关于在现有 AID 系统中使用超速效胰岛素类似物的报告，但实际上所有这些报告都没有发现明显的益处。 3-5 在此，我们报告了一名血糖控制良好的患者在使用 URLi 和 Control-IQ 时血糖控制得到改善的案例。据我们所知，这是第一份结合 Control-IQ 使用超速效胰岛素的报告。我们比较了一名 19 岁 1D 女性从其初级保健办公室获得 URLi 的连续血糖监测 (CGM) 和泵数据。她将 URLi 与采用 Control-IQ 技术的 Tandem t: slimX2 泵一起使用（13 周），然后恢复使用门冬胰岛素（4 周），而没有改变与膳食摄入相关的推注时间（根据 CGM 趋势，进食前 0-15 分钟）。两种胰岛素类似物的平均每日总胰岛素相似（48.6 U 与 46.9 U）。患者在整个分析时间段内遵循低碳水化合物饮食，
Dear Editor, Postprandial glycemic control remains challenging for people with type 1 diabetes (T1D) even with the use of newer technologies such as automated insulin delivery (AID) systems. Newer insulin formulations aim to decrease postprandial glucose excursions through the use of excipients that accelerate insulin absorption. Ultrarapid lispro (URLi) has been found to be superior to traditional analogs at controlling postprandial glucose in adults with diabetes using both multiple daily injections1 and continuous insulin infusion. 2 At this time, several reports have been published on the use of ultrarapid acting insulin analogs in the AID systems that are currently available, however, virtually all of these reports found no clear benefit. 3–5 Here we report a case of improved glycemic control in an already well-controlled patient while using URLi with Control-IQ. To the best of our knowledge, this is the first report of ultrarapid acting insulin use with Control-IQ.We compared continuous glucose monitoring (CGM) and pump data in a 19-year-old female with T1D who obtained URLi from her primary care office. She used URLi with her Tandem t: slimX2 pump with Control-IQ technology (13 weeks), then returned to using insulin aspart (4 weeks) without altering the timing of her boluses in relation to meal intake (0–15 min before eating based on CGM trends). Average total daily insulin was similar with both insulin analogs (48.6 U vs. 46.9 U). The patient followed a low carbohydrate diet throughout the time period analyzed, with