通过自制人工胰腺系统对中国1型糖尿病儿童进行有效的血糖控制：一项单中心研究。
Effective blood glucose control in Chinese children with type 1 diabetes via a do-it-yourself artificial pancreas system: a single-center study.
作者信息
Yang Lihong, Xie Fei, Han Linqi, You Fengyan, Wei Zhiqiang, Liu Caihong, Xu Chao, Sun Yan
机构信息
Paediatrics, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Department of Paediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
出版信息
Ther Adv Endocrinol Metab. 2025 Jul 13;16:20420188251347028. doi: 10.1177/20420188251347028. eCollection 2025.
BACKGROUND/PURPOSE: The artificial pancreas system is among the most advanced devices for blood glucose management and is known to improve patients' glycated hemoglobin levels and time spent within the target glucose range. However, the use of an artificial pancreas in children with type 1 diabetes (T1D) in China has not yet been reported.
METHODS
A retrospective study was conducted involving patients diagnosed with T1D who used a do-it-yourself artificial pancreas system (DIYAPS). The main inclusion criteria were as follows: T1D diagnosis, age between 3 and 18 years, usage of an insulin pump, and continuous glucose monitoring records for at least 3 months. The exclusion criterion was any comorbid conditions that could interfere with the study. The primary outcomes measured were changes in hemoglobin A1c (HbA1c) and time in range (TIR) before and after the DIYAPS was used.
RESULTS
A total of 41 people were included in the study, including 21 males and 20 females, with a mean age of 9.4 years (standard deviation: 2.9 years), a median duration of T1D of 1.5 years (1.1-2.3), and a median duration of insulin pump use of 1.1 years (0.8-1.7). Compared with the baseline period (pre-DIYAPS), after using a DIYAPS, the TIR increased from 72.4% (57.9-82.4) to 80.8% (73.6-87.5; < 0.01), the TAR (>10 mmol/L) decreased from 16.0% (8.2-21.2) to 8.8% (5.2-14.4; < 0.01), the fasting blood glucose decreased from 8.2 mmol/L (7.2-9.4) to 6.7 mmol/L (6.3-7.6; < 0.01), and the HbA1c decreased from 6.6% (6.1-7.6) to 6.3% (5.9-6.9; < 0.05). No diabetic ketoacidosis, severe hypoglycemia, or other adverse events occurred during the use of the DIYAPS.
CONCLUSION
DIYAPS is safe and effective in Chinese children with T1D, particularly in improving TIR.
背景/目的：人工胰腺系统是用于血糖管理的最先进设备之一，已知可改善患者的糖化血红蛋白水平以及处于目标血糖范围内的时间。然而，在中国1型糖尿病（T1D）儿童中使用人工胰腺的情况尚未见报道。
方法
进行了一项回顾性研究，纳入使用自制人工胰腺系统（DIYAPS）的T1D确诊患者。主要纳入标准如下：T1D诊断、年龄在3至18岁之间、使用胰岛素泵以及至少3个月的连续血糖监测记录。排除标准为任何可能干扰研究的合并症。测量的主要结局是使用DIYAPS前后糖化血红蛋白（HbA1c）和血糖达标时间（TIR）的变化。
结果
共纳入41人，包括21名男性和20名女性，平均年龄9.4岁（标准差：2.9岁），T1D的中位病程为1.5年（1.1 - 2.3），胰岛素泵使用的中位时长为1.1年（0.8 - 1.7）。与基线期（使用DIYAPS前）相比，使用DIYAPS后，TIR从72.4%（57.9 - 82.4）增至80.8%（73.6 - 87.5；P < 0.01），高血糖时间（TAR，>10 mmol/L）从16.0%（8.2 - 21.2）降至 8.8%（5.2 - 14.4；P < 0.01），空腹血糖从8.2 mmol/L（7.2 - 9.4）降至6.7 mmol/L（6.3 - 7.6；P < 0.01），HbA1c从6.6%（6.1 - 7.6）降至6.3%（5.9 - 6.9；P < 0.05）。使用DIYAPS期间未发生糖尿病酮症酸中毒、严重低血糖或其他不良事件。
结论
DIYAPS在中国T1D儿童中安全有效，尤其在改善TIR方面。
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