成人1型糖尿病患者使用胰岛素泵治疗血糖达标的影响因素
Factors associated with glycemic control in adults with type 1 diabetes mellitus with insulin pump treatment
目的：探讨影响使用胰岛素泵治疗的成人1型糖尿病患者血糖达标的影响因素。方法： 研究对象来自广东省1型糖尿病转化医学研究，年龄大于18岁，使用胰岛素泵治疗6个月以上的1型糖尿病患者。根据糖化血红蛋白<7.0%的标准，分为达标组（n=59）和不达标组（n=49），Logistic回归模型分析血糖达标的相关因素。结果： 108例患者纳入分析（女/男：75/33），中位年龄32.0岁，中位病程7.9年。多因素分析校正了年龄、病程、空腹C肽后，胰岛素基础量（0.2-0.3）IU/kg 4.48(95% CI 1.53-13.15, p =0.00)、高自我血糖监测频率 1.31 (95%CI 1.05-1.63, p =0.01)及男性3.43(95%CI 1.18-10.01, p =0.02)与血糖达标相关。结论： 对于胰岛素泵治疗的成人1型糖尿病患者，合适的基础量和较高频次的自我血糖监测是获得良好血糖控制的关键。
Objective：Our study aimed to identify factors associated with glycemic control in adults with type 1 diabetes mellitus (T1D) treated with insulin pump. Methods：108 patients with age older than 18 years and with insulin pump therapy for > 6 months were selected from 16 centers of Guangdong Type 1 diabetes Translational Medicine Study. Participants were classified into two groups according to the ADA Hemoglobin A1c target (7.0%). Those reached the target (n=59) were compared with those failed (n=49) using ANOVA and logistic regression. Results：Of the 108 participants (33Males), median of age was 32.0 (25.9,40.9) years, median of duration 7.9（4.2, 12.3）years. Logistic regression analysis revealed an odds ratio of 4.48(95% CI 1.53-13.15, p =0.00) for total daily basal insulin dose within 0.2-0.3 units per kilogram, an odds ratio equal to 1.31 (95%CI 1.05-1.63, p =0.01) for self-monitoring of blood glucose（SMBG）, and an odds ratio of 3.43 (95%CI 1.18-10.01, p =0.02) for male. Conclusions：Higher frequencies of SMBG and appropriate basal insulin dose are essential to adult patients with T1D used insulin pump.)
严晋华、章燕、翁建平
内科学临床医学基础医学
1型糖尿病胰岛素泵糖化血红蛋白
iabetes Mellitus Type 1Insulin infusion systemsHemoglobin A，Glycosylate
严晋华,章燕,翁建平.成人1型糖尿病患者使用胰岛素泵治疗血糖达标的影响因素[EB/OL].(2014-10-27)[2025-08-06].http://www.paper.edu.cn/releasepaper/content/201410-321.点此复制
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