Diabetic Ketoacidosis at Onset of Type 1 Diabetes and Glycemic Outcomes with Closed-Loop Insulin Delivery

被引：5

作者：

Lakshman, Rama ^{[1
,11
]}

Najami, Mazin ^{[1
]}

Allen, Janet M. ^{[1
,2
]}

Ware, Julia ^{[1
,2
]}

Wilinska, Malgorzata E. ^{[1
,2
]}

Hartnell, Sara ^{[3
]}

Thankamony, Ajay ^{[2
]}

Randell, Tabitha ^{[4
]}

Ghatak, Atrayee ^{[5
]}

Besser, Rachel E. J. ^{[6
,7
]}

Elleri, Daniela ^{[8
]}

Trevelyan, Nicola ^{[9
]}

Campbell, Fiona M. ^{[10
]}

Hovorka, Roman ^{[1
,2
]}

Boughton, Charlotte K. ^{[1
,3
]}

机构：

[1] Univ Cambridge, Wellcome MRC Inst Metab Sci, Cambridge, England

[2] Univ Cambridge, Dept Psychol, Cambridge, England

[3] Cambridge Univ Hosp NHS Fdn Trust, Wolfson Diabet & Endocrine Clin, Cambridge, England

[4] Nottingham Childrens Hosp, Dept Paediat Diabet & Endocrinol, Nottingham, England

[5] Alder Hey Childrens NHS Fdn Trust, Dept Diabet, Liverpool, England

[6] Univ Oxford, Dept Paediat, Oxford, England

[7] John Radcliffe Hosp, NIHR Oxford Biomed Res Ctr, Oxford, England

[8] Royal Hosp Sick Children, Dept Diabet, Edinburgh, Scotland

[9] Southampton Childrens Hosp, Paediat Diabet, Southampton, England

[10] Leeds Childrens Hosp, Dept Paediat Diabet, Leeds, England

[11] Univ Cambridge, Wellcome MRC Inst Metab Sci, Cambridge CB2 0QQ, England

来源：

DIABETES TECHNOLOGY & THERAPEUTICS | 2024年 / 26卷 / 03期

关键词：

Type; 1; diabetes; Artificial pancreas; Closed-loop systems; Diabetic ketoacidosis; CHILDREN; ADOLESCENTS; PREDICTOR; HBA(1C);

D O I：

10.1089/dia.2023.0307

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The presence of diabetic ketoacidosis (DKA) at diagnosis of type 1 diabetes (T1D) is associated with higher glycated hemoglobin levels over time. We evaluated whether hybrid-closed loop (HCL) therapy from onset of T1D could prevent the adverse impact of DKA at diagnosis on long-term glycemic outcomes. This was a posthoc analysis from 51 adolescents using HCL from diagnosis of T1D as part of the CLOuD trial (NCT02871089). We compared glycemic and insulin metrics between adolescents with (n = 17) and without (n = 34) DKA at diagnosis. Participants with and without DKA at diagnosis had similar time in target glucose range 3.9-10.0 mmol/L (70-180 mg/dL), time below range (<3.9 mmol/L, <70 mg/dL) and HbA1c at 6, 12, and 24 months. While insulin requirements at 6 months were higher in those with DKA at diagnosis, this was not statistically significant after adjusting for bodyweight. Residual C-peptide secretion was similar between groups. We conclude that HCL therapy may mitigate against the negative glycemic effects of DKA at T1D diagnosis.

引用

页码：198 / 202

页数：5

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