Insulin Pump Use and Diabetic Ketoacidosis Risk in Type 1 Diabetes: Secular Trends over Four Decades

被引：4

作者：

Budhram, Dalton R. ^{[1
,2
]}

Bapat, Priya ^{[1
,3
]}

Bakhsh, Abdulmohsen ^{[1
,3
,4
]}

Abuabat, Mohammad I. ^{[1
,3
,5
]}

Verhoeff, Natasha J. ^{[1
,6
]}

Mumford, Doug ^{[1
]}

Cheema, Wajeeha ^{[1
]}

Orszag, Andrej ^{[1
,3
]}

Jain, Akshay ^{[7
,8
]}

Cherney, David Z. I. ^{[6
,9
]}

Fralick, Michael ^{[1
,2
]}

Alamri, Bader N. ^{[10
]}

Weisman, Alanna ^{[1
,3
,11
]}

Lovblom, Leif Erik ^{[12
]}

Perkins, Bruce A. ^{[1
,3
,11
]}

机构：

[1] Mt Sinai Hosp, Lunenfeld Tanenbaum Res Inst, Toronto, ON, Canada

[2] Univ Toronto, Univ Hlth Network & Sinai Hlth, Div Gen Internal Med & Geriatr, Toronto, ON, Canada

[3] Univ Toronto, Dept Med, Div Endocrinol, Toronto, ON, Canada

[4] King Faisal Specialist Hosp & Res Ctr, Kidney & Pancreas Hlth Ctr, Organ Transplant Ctr Excellence, Riyadh, Saudi Arabia

[5] Princess Norah Univ, King Abdullah Bin Abdulaziz Univ Hosp, Dept Internal Med & Crit Care, Riyadh, Saudi Arabia

[6] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada

[7] TLC Diabet & Endocrinol, Surrey, BC, Canada

[8] Univ British Columbia, Dept Med, Div Endocrinol, Vancouver, BC, Canada

[9] Univ Hlth Network, Dept Med, Div Nephrol, Toronto, ON, Canada

[10] McMaster Univ, Dept Med, Div Endocrinol & Metab, Hamilton, ON, Canada

[11] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[12] Univ Hlth Network, Dept Biostat, Toronto, ON, Canada

来源：

DIABETES TECHNOLOGY & THERAPEUTICS | 2025年 / 27卷 / 02期

关键词：

type; 1; diabetes; insulin pumps; diabetic ketoacidosis; diabetes technology; GLYCEMIC CONTROL; ADULTS; INJECTIONS;

D O I：

10.1089/dia.2024.0272

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Continuous subcutaneous insulin infusion (CSII) in type 1 diabetes has been regarded as a major diabetic ketoacidosis (DKA) risk factor. We aimed to determine secular trends in risk since CSII implementation in the 1980s. Research Design and Methods: We assessed the relationship between time-varying CSII use and DKA events from 1983 to 2017 and by each decade in the 1441 Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study participants using crude and adjusted Cox proportional hazards models. Results: Time-varying CSII exposure was associated with significantly higher DKA risk in the 1980s (adjusted hazard ratio [HR] 5.81; 95% confidence interval [CI] 3.28-10.29; P < 0.001), but in the 2010s, this risk was not significantly elevated (adjusted HR 1.24; 95% CI 0.73-2.12; P = 0.43). Conclusions: DKA risk associated with CSII in type 1 diabetes has declined substantially since the 1980s such that the remaining risk in the past decade appears to be of low magnitude.

引用

页码：139 / 143

页数：5

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