Preventing Post-Exercise Nocturnal Hypoglycemia in Children with Type 1 Diabetes
Preventing Post-Exercise Nocturnal Hypoglycemia in Children with Type 1 Diabetes
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DOI：
10.1016/j.jpeds.2010.06.004
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发表时间：
2010-11-01
影响因子：
5.1
通讯作者：
Fiallo-Scharer, Rosanna
中科院分区：
文献类型：
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作者：
Taplin, Craig E.;Cobry, Erin;Fiallo-Scharer, Rosanna
目的探讨降低夜间基础胰岛素或睡前剂量特布他林对1型糖尿病儿童运动后夜间血糖（BG）最低点和低血糖的影响。研究设计：16名青少年（平均年龄13.3岁）在进行60分钟的运动后，每30分钟测量一次血糖，并使用胰岛素泵进行3次夜间研究。入院患者随机接受睡前治疗，口服特布他林2.5 mg， 20%基础率胰岛素降低6小时，或不治疗。结果与对照组127 mg/dL相比，特布他林治疗组平均夜间最低BG为188 mg/dL，基础速率降低为172 mg/dL （P = 0.002, P = 0.002）。042年,分别)。特布他林消除了夜间低血糖，但与对照组相比，高血糖发生率明显增加（>= 250 mg/dL） （P < 0.0001）。与对照组相比，基础速率降低导致BG读数< 80和< 70 mg/dL减少，但>= 250 mg/dL的读数增加。结论降低基础胰岛素率对提高1型糖尿病儿童运动后夜间血糖最低点和降低低血糖是安全有效的。尽管特布他林对预防低血糖有效，但2.5 mg剂量的特布他林与高血糖有关。[J] .中华儿科杂志2010；57:784- 888。
Objective To determine the effects of reducing overnight basal insulin or a bedtime dose of terbutaline on nocturnal blood glucose (BG) nadir and hypoglycemia after exercise in children with type 1 diabetes mellitus.Study design Sixteen youth (mean age 13.3 years) on insulin pumps were studied overnight on 3 occasions after a 60-minute exercise session with BG measurements every 30 minutes. Admissions were randomized to bedtime treatment with oral terbutaline 2.5 mg, 20% basal rate insulin reduction for 6 hours, or no treatment.Results Mean overnight nadir BG was 188 mg/dL after terbutaline and 172 mg/dL with basal rate reduction compared with 127 mg/dL on the control night (P = .002 and .042, respectively). Terbutaline eliminated nocturnal hypoglycemia but resulted in significantly more hyperglycemia (>= 250 mg/dL) when compared with the control visit (P < .0001). The basal rate reduction resulted in fewer BG readings < 80 and < 70 mg/dL but more readings >= 250 mg/dL when compared with the control visit.Conclusions A basal insulin rate reduction was safe and effective in raising post-exercise nocturnal BG nadir and in reducing hypoglycemia in children with type 1 diabetes mellitus. Although effective at preventing hypoglycemia, a 2.5-mg dose of terbutaline was associated with hyperglycemia. (J Pediatr 2010; 157:784-8).