Use of an artificial pancreas among adolescents for a missed snack bolus and an underestimated meal bolus
Use of an artificial pancreas among adolescents for a missed snack bolus and an underestimated meal bolus
复制标题
DOI：
10.1111/pedi.12230
复制
发表时间：
2016-02-01
影响因子：
3.4
通讯作者：
Breton, Marc D.
中科院分区：
文献类型：
--
作者：
Chernavvsky, Daniel R.;DeBoer, Mark D.;Breton, Marc D.
目的：本研究的目的是评价人工胰腺（AP）在青少年1型糖尿病（T1 D）患者中胰岛素遗漏后的安全性和性能。研究设计和方法：在一项随机交叉试验中，年龄在13- 18岁的T1 D青少年被纳入一项随机交叉试验。在不同日期，通过家庭胰岛素泵接受常规护理（UC）或使用AP系统（糖尿病助手平台、动态血糖监测仪和胰岛素泵）。入院后约1小时，两组受试者均接受了30 g碳水化合物的突击零食，4小时后，他们接受了80 g午餐，两组仅接受了计算胰岛素剂量的75%以覆盖碳水化合物。在UC当天（但不是AP当天），他们在午餐时接受了完整的高血糖（BG）校正因子。每次入院持续约8 h。结果：共有16名参与者完成了试验。在AP当天（与UC相比），平均BG较低（197 +/- 10 vs. 235 +/- 14 mg/ dL），70- 180 mg/ dL范围内的时间总体较高（43%+/- 7 vs. 19%+/- 7）（均为p< 0.05）;这些结果在零食和膳食后的时间内保持不变（也为p< 0.05）。在试验期间，低血糖< 70 mg/ dL的发生率在两组之间没有差异。结论：AP提供了短期血糖控制的改善，而没有增加低血糖后错过胰岛素的青少年食物。因此，AP部分补偿了错过的食物胰岛素推注，这在青少年糖尿病护理中很常见。需要在更长期的环境中进行进一步的测试。
Objective: The objective of this study was to evaluate the safety and performance of the artificial pancreas ( AP) in adolescents with type 1 diabetes ( T1D) following insulin omission for food. Research design and methods: In a randomized, cross- over trial, adolescents with T1D aged 13- 18 yr were enrolled in a randomized, cross- over trial. On separate days, received either usual care ( UC) through their home insulin pump or used an AP system ( Diabetes Assistant platform, continuous glucose monitor, and insulin pump). Approximately 1 h after admission, participants in both groups received an unannounced snack of 30 g carbohydrate, and 4 h later they received an 80 g lunch, for which both groups only received 75% of the calculated insulin dose to cover carbohydrates. On the UC day ( but not the AP day), they received their full high blood glucose ( BG) correction factor at lunch. Each admission lasted approximately 8 h. Results: A total of 16 participants completed the trial. On the AP day ( compared to UC), mean BG was lower ( 197 +/- 10 vs. 235 +/- 14 mg/ dL) and time in range 70- 180 mg/ dL was higher ( 43%+/- 7 vs. 19%+/- 7) ( both p< 0.05) overall; these results held in the time following the snack and meal ( also p< 0.05). During the trial, there were no differences between groups in the rate of hypoglycemia < 70 mg/ dL. Conclusions: The AP provided improvements in short- term glycemic control without increases in hypoglycemia following missed insulin for food in adolescents. Thus, the AP partly compensates for missed insulin boluses for food, a common occurrence in adolescent diabetes care. Further testing is needed in longer- term settings.