Establishing glycaemic control with continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes: experience of the PedPump Study in 17 countries

被引：103

作者：

Danne, T. ^{[1
]}

Battelino, T. ^{[2
]}

Jarosz-Chobot, P. ^{[3
]}

Kordonouri, O. ^{[4
]}

Pankowska, E. ^{[5
]}

Ludvigsson, J. ^{[6
]}

Schober, E. ^{[7
]}

Kaprio, E. ^{[8
]}

Saukkonen, T. ^{[9
]}

Nicolino, M. ^{[10
]}

Tubiana-Rufi, N. ^{[11
]}

Klinkert, C. ^{[12
]}

Haberland, H. ^{[13
]}

Vazeou, A. ^{[14
]}

Madacsy, L. ^{[15
]}

Zangen, D. ^{[16
]}

Cherubini, V. ^{[17
]}

Rabbone, I. ^{[18
]}

Toni, S. ^{[19
]}

de Beaufort, C. ^{[20
]}

Waarde, W. Bakker-van ^{[21
]}

van den Berg, N. ^{[22
]}

Volkov, I. ^{[33
]}

Barrio, R. ^{[32
]}

Hanas, R. ^{[31
]}

Zumsteg, U. ^{[30
]}

Kuhlmann, B.

Aebi, C. ^{[29
]}

Schumacher, U. ^{[28
]}

Gschwend, S. ^{[27
]}

Hindmarsh, P. ^{[26
]}

Torres, M. ^{[25
]}

Shehadeh, N. ^{[24
]}

Phillip, M. ^{[23
]}

机构：

[1] Kinderkrankenhaus Bult, Janusz Korczak Allee 12, D-30173 Hannover, Germany

[2] Univ Childrens Hosp, Ljubljana, Slovenia

[3] Med Univ Silesia, Katowice, Poland

[4] Charite, Pediat Clin, Berlin, Germany

[5] Med Univ Warsaw, Warsaw, Poland

[6] Linkoping Univ, Div Pediat & Diabet Res Ctr, Linkoping, Sweden

[7] Univ Childrens Hosp, Vienna, Austria

[8] Peijas Univ Hosp, Vantaa, Finland

[9] HUCH Hosp Children & Adolescents, Helsinki, Finland

[10] CHU Debrousse, Lyon, France

[11] APPH, CHU Robert Debre, Paris, France

[12] Heart & Diabet Ctr Nordrhein, Westfalen, Bad Oeynhausen, Germany

[13] Clin Lindenhof, Berlin, Germany

[14] PA Kyriakou Childrens Hosp, Athens, Greece

[15] Semmelweis Univ, H-1085 Budapest, Hungary

[16] Hadassah Hebrew Univ Med Ctr, Jerusalem, Israel

[17] Polytechn Univ Marche, Salesi Hosp, Ancona, Italy

[18] Univ Turin, Dept Paediat, Turin, Italy

[19] Meyer Paediat Inst, Florence, Italy

[20] DCCP Pediat Clin Luxembourg, Luxembourg, Luxembourg

[21] Univ Groningen, Univ Med Ctr Groningen, Beatrix Children Hosp, Groningen, Netherlands

[22] Flevo Childrens Hosp, Almere, Netherlands

[23] Schneider Childrens Med Ctr Israel, Petah Tiqwa, Israel

[24] Mayer Children Hosp, Haifa, Israel

[25] Hosp San Juan Dios, Barcelona, Spain

[26] London Ctr Paediat Endocrinol & Diabet, London, England

[27] Kantonsspital Zug, Zug, Switzerland

[28] Kantonspital Munsterlingen, Munsterlingen, Switzerland

[29] Childrens Hosp Wildermeth Spitalzentrum Biel, Biel, Switzerland

[30] Univ Childrens Hosp, Basel, Switzerland

[31] Uddevalla Cent Hosp, Uddevalla, Sweden

[32] Hosp Ramon & Cajal, E-28034 Madrid, Spain

[33] Russian Childrens Clin Hosp, Moscow, Russia

来源：

DIABETOLOGIA | 2008年 / 51卷 / 09期

关键词：

adolescents; children; diabetic; HbA(1c); hypoglycaemia; insulin infusion systems; ketoacidosis; type 1 diabetes mellitus;

D O I：

10.1007/s00125-008-1072-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims/hypothesis To assess the use of paediatric continuous subcutaneous infusion (CSII) under real-life conditions by analysing data recorded for up to 90 days and relating them to outcome. Methods Pump programming data from patients aged 0-18 years treated with CSII in 30 centres from 16 European countries and Israel were recorded during routine clinical visits. HbA(1c) was measured centrally. Results A total of 1,041 patients (age: 11.8 +/- 4.2 years; diabetes duration: 6.0 +/- 3.6 years; average CSII duration: 2.0 +/- 1.3 years; HbA(1c): 8.0 +/- 1.3% [means +/- SD]) participated. Glycaemic control was better in preschool (n=142; 7.5 +/- 0.9%) and pre-adolescent (6-11 years, n=321; 7.7 +/- 1.0%) children than in adolescent patients (12-18 years, n=578; 8.3 +/- 1.4%). There was a significant negative correlation between HbA(1c) and daily bolus number, but not between HbA(1c) and total daily insulin dose. The use of < 6.7 daily boluses was a significant predictor of an HbA(1c) level > 7.5%. The incidence of severe hypoglycaemia and ketoacidosis was 6.63 and 6.26 events per 100 patient-years, respectively. Conclusions/interpretation This large paediatric survey of CSII shows that glycaemic targets can be frequently achieved, particularly in young children, and the incidence of acute complications is low. Adequate substitution of basal and prandial insulin is associated with a better HbA(1c).

引用

页码：1594 / 1601

页数：8

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