学龄前期儿童新发1型糖尿病胰岛素泵基础率设置探讨

Basal Rate Delivery of Insulin Pump in Preschool Children with Newly Diagnosed Type 1 Diabetes

目的:探讨学龄前期儿童新发1型糖尿病胰岛素泵基础率设置方法,提高家长控糖信心。方法:收集2013年9月至2017年3月郑州大学附属儿童医院内分泌遗传代谢科收治的3~6岁新发1型糖尿病患儿临床资料,在纠正酮症酸中毒后或直接应用胰岛素泵皮下持续输注胰岛素控制血糖,同时按照食物交换份法制定标准食谱。起始每日胰岛素泵总量为0.8~1.0 IU/kg,基础率设定为胰岛素总量50%,以七段法为基础,每天监测8次血糖。选取血糖达标且胰岛素泵基础率连续2 d不再变化为时间截点,同时采集患儿相关数据进行统计分析。结果:本研究共纳入30例患儿,男18例,女12例,胰岛素泵基础率0:00-6:00最低,16:00-20:00最高。结论:学龄前期儿童新发1型糖尿病黎明现象不显著,进行胰岛素基础率设置时需注意学龄前期儿童胰岛素泵基础率特点。

Objective:To explore the basal rate delivery of insulin pump in preschool children with newly diagnosed type 1 diabetes,so as to improve parents’confidence in blood glucose control.Methods:Clinical data of children from 3 to 6 years with newly diagnosed type 1 diabetes in Children’s Hospital Affiliated to Zhengzhou University from Sept.2013 to Mar.2017 were collected.All children were treated with subcutaneous insulin pump immediately or after the correction of ketoacidosis.The standard diet was formulated in accordance with the food exchange portion.The initial total daily insulin dosage in insulin pump was from 0.8 to 1.0 IU/kg.The initial insulin pump basal rate was set to 50%of the total insulin dosage and divided into 7 segments based on clinical experience.The blood glucose was monitored for 8 times a day.The time cut-off point was selected as the blood glucose reached the target level and the basal rate of insulin pump did not change for 2 d.Meanwhile,relevant data of the children were collected for statistical analysis.Results:A total of 30 children were enrolled in this study,including 18 males and 12 females.The dose of insulin pump basal rate was the lowest from 0:00 to 6:00,and the highest from 16:00 to 20:00.Conclusion:The dawn phenomenon of newly diagnosed type 1 diabetes in preschool children is not significant.When setting the basal rate delivery of insulin pump,attention should be paid to the characteristics of the basal insulin pump rate in preschool children.