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早期启用糖尿病设备与近期发病 1 型糖尿病儿童血糖控制改善有关。

Early Initiation of Diabetes Devices Relates to Improved Glycemic Control in Children with Recent-Onset Type 1 Diabetes Mellitus.

机构信息

1 Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas.

2 Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, Missouri.

出版信息

Diabetes Technol Ther. 2019 Jul;21(7):379-384. doi: 10.1089/dia.2019.0026. Epub 2019 Jun 5.

Abstract

To test whether the addition of an insulin pump or continuous glucose monitor (CGM) related to reduced glycated hemoglobin A1c (HbA1c) in large cohort of children, 5-9 years old, and within 1 year of their type 1 diabetes (T1D) diagnosis. The study uses data from families of children with recent-onset T1D and who were between 5 and 9 years old. Study analyses used children's HbA1c values at baseline and at the 6-month follow-up. Parents reported on family demographics and children's T1D device use in their daily management (e.g., insulin pump or CGM). Children's mean T1D duration was 4.70 ± 3.28 months at baseline, so the 6-month assessment point was ∼12 months postdiagnosis. One hundred-eleven families participated. At baseline, child mean age was 7.51 ± 1.37 years, and mean child HbA1c was 7.65% ± 1.40%. In addition, 17% of children used an insulin pump, and 17.1% of children used CGM. Six months later, 35.1% of children had started an insulin pump and 25.2% had started CGM. Repeated measures analyses of variance results showed a smaller overall HbA1c between baseline and 6 months for children using an insulin pump versus children not on a pump. For CGM, results showed that children starting a CGM during this window had a significantly lower HbA1c level than children who had not started on CGM. The study results suggest that early initiation of either an insulin pump or CGM in children newly diagnosed with T1D may help to improve child HbA1c levels within the first 12 months of diabetes.

摘要

为了测试在大型儿童队列(年龄 5-9 岁,1 年内确诊 1 型糖尿病(T1D))中,添加胰岛素泵或连续血糖监测(CGM)是否与糖化血红蛋白 A1c(HbA1c)降低有关。该研究使用了近期确诊 T1D 且年龄在 5-9 岁的儿童家庭的数据。研究分析使用了儿童基线和 6 个月随访时的 HbA1c 值。父母报告了家庭人口统计学信息以及儿童在日常管理中使用 T1D 设备的情况(例如,胰岛素泵或 CGM)。儿童的平均 T1D 持续时间为基线时的 4.70±3.28 个月,因此 6 个月评估点约为诊断后 12 个月。有 111 个家庭参与了该研究。基线时,儿童平均年龄为 7.51±1.37 岁,平均儿童 HbA1c 为 7.65%±1.40%。此外,17%的儿童使用胰岛素泵,17.1%的儿童使用 CGM。6 个月后,35.1%的儿童开始使用胰岛素泵,25.2%的儿童开始使用 CGM。重复测量方差分析结果显示,使用胰岛素泵的儿童在基线和 6 个月之间的整体 HbA1c 水平较低,而未使用胰岛素泵的儿童则较高。对于 CGM,结果显示在此窗口期间开始使用 CGM 的儿童的 HbA1c 水平明显低于未开始使用 CGM 的儿童。研究结果表明,在新诊断为 T1D 的儿童中早期开始使用胰岛素泵或 CGM 可能有助于在糖尿病确诊后的前 12 个月内改善儿童的 HbA1c 水平。

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