| Autor: |
Barash, Galia, Lerman, Liat, Ben-Ari, Tal, Abiri, Shirly, Landau, Zohar, Ben Ami, Michal, Brener, Avivit, Lebenthal, Yael, Pinhas-Hamiel, Orit, Mazor-Aronovitch, Kineret, Haim, Alon, Yeshayahu, Yonatan, De Vries, Liat, Rachmiel, Marianna |
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| Zdroj: |
Acta Diabetologica; Oct2024, Vol. 61 Issue 10, p1241-1249, 9p |
| Abstrakt: |
Background: Poorly controlled adolescents living with type 1 diabetes (T1D) and pump failure of insulin delivery leading to diabetic ketoacidosis (DKA) are still challenging in the western world. Aim: To investigate the effect of a combination modality of long-acting insulin for basal coverage and a pump for boluses, on the incidence of DKA and glycemic parameters in pediatric and young adults with poorly controlled T1D. Methods: This multicenter, observational retrospective study included 55 patients (age range 3–25 years, 52.7% males) who were treated with the combination modality for a median of 18 months [(IQR)12,47], as part of their clinical care. Data were retrieved at initiation of the combined modality, after 6 months, and at last visit. Results: Cohort's median age at combination modality initiation was 14.5 years [IQR12.4,17.3], and its median HbA1c level was 9.2% [IQR 8.2,10.2]. The main reasons for combination modality initiation were: (a) concern about sustained hyperglycemia on current management in 41.8%, (b) previous DKA episodes in 30.8%, and (c) refusal to wear a pump continuously in 14.6%. The percent of patients experiencing DKA who used the modality till end decreased from 25.4 to 8.8%. The frequency of DKA events per patient month decreased after 6 months from 0.073 (min 0, max 0.5) to 0.020 (min 0, max 0.5), p = 0.01, and at end to 0.016 (min 0, max 0.25), p = 0.007. Conclusions: The combination modality of once-daily long-acting insulin and pump for boluses is safe, feasible, and effective in preventing DKA among poorly controlled young people living with T1D, unable or un-willing to use advanced closed pumps. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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