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应用人工胰的糖尿病营夜间血糖调控
Nocturnal Glucose Control with an Artificial Pancreas at a Diabetes Camp


Moshe Phillip ... 糖尿病 • 2013.02.28
相关阅读
• 人工胰腺疗法改善1型糖尿病的血糖控制

摘要


背景

近期研究表明一种人工胰系统能够改善血糖调控,减少夜间低血糖的发生。然而,尚不了解这样的结果能否在院外的条件下重复。


方法

在这项多中心、多国、随机交叉试验中,我们评估了1型糖尿病患者(10~18岁)应用人工胰控制夜间血糖的短期安全性及有效性。在连续两个晚上的时间,我们随机指定56名患者在首夜应用人工胰,次夜应用传感器增强的胰岛素泵或者两个晚上接受治疗的顺序相反。这样,所有的患者都通过随机指定的顺序接受不同的处理。主要终点为发生低血糖事件的次数(定义为血糖值低于63 mg/dL,即3.5 mmol/L,并至少持续10分钟),血糖值低于60 mg/dL(3.3 mmol/L)持续的时间,以及患者夜间的平均血糖水平。


结果

使用人工胰的夜间与使用传感器增强的胰腺泵的夜间相比较,血糖低于63 mg/dL的发作次数明显减少(分别为7 mg/dL和22 mg/dL),血糖低于60 mg/dL的持续时间也明显缩短(经过多重检验调整的P值分别为0.003和0.02)。应用人工胰的个体夜间平均血糖值的中位数在126.4 mg/dL(四分位间距:115.7~139.1 mg/dL [7.0 mmol/L;四分位间距:6.4~7.7 mg/dL])而应用胰岛素泵的个体平均夜间血糖在140.4 mg/dL(四分位间距,105.7~167.47.8 mg/dL [7.8 mmol/L;四分位间距:5.9~9.3 mg/dL])。尚未有严重不良事件的报道。


结论

应用人工胰的参加糖尿病营患者与应用传感器增强胰岛素泵的患者相比发生夜间低血糖的事件更少,而且前者与后者相比夜间血糖的波动也比较小(由赛诺菲[Sanofi]等资助;ClinicalTrials.gov注册号为NCT01238406)。





作者信息

Moshe Phillip, M.D., Tadej Battelino, M.D., Eran Atlas, M.Sc., Olga Kordonouri, M.D., Natasa Bratina, M.D., Shahar Miller, B.Sc., Torben Biester, M.D., Magdalena Avbelj Stefanija, M.D., Ido Muller, B.Sc., Revital Nimri, M.D., and Thomas Danne, M.D.
From the Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva (M.P., E.A., S.M., I.M., R.N.), and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv (M.P.) — both in Israel; the Department of Pediatric Endocrinology, Diabetes and Metabolism, University Medical Center-University Children's Hospital, and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia (T. Battelino, N.B., M.A.S.); and the Diabetes Center for Children and Adolescents, Auf der Bult, Kinder- und Jugendkrankenhaus, Hannover, Germany (O.K., T. Biester, T.D.). Address reprint requests to Dr. Phillip at the Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, 14 Kaplan St., Petah Tikva, 49202 Israel, or at mosheph@post.tau.ac.il.

 

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