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BMJ:胰岛素泵治疗可降低1型糖尿病患者心血管死亡率的50%

2015-08-12 MedSci译 MedSci原创

BMJy:胰岛素泵治疗可降低1型糖尿病患者心血管死亡率的50%据发表于BMJ的一项研究表明,使用胰岛素泵治疗的1型糖尿病患者较使用胰岛素注射治疗的1型糖尿病患者死于心血管疾病的风险较小(约50%)。基于瑞典国家糖尿病登记数据,2005年-2012年研究人员监测了18168名1型糖尿病患者。其中2441名患者使用胰岛素泵治疗,其他患者则应用胰岛素每日多次注射治疗。低风险研究人员发现,胰岛素泵使用者死




据发表于BMJ的一项研究表明,使用胰岛素泵治疗的1型糖尿病患者较使用胰岛素注射治疗的1型糖尿病患者死于心血管疾病的风险较小(约50%)。

基于瑞典国家糖尿病登记数据,2005年-2012年研究人员监测了18168名1型糖尿病患者。其中2441名患者使用胰岛素泵治疗,其他患者则应用胰岛素每日多次注射治疗。

低风险

研究人员发现,胰岛素泵使用者死于心血管疾病的风险明显小于依赖胰岛素注射治疗的患者。
“消除偏倚及混杂因素后仔细分析我们发现,胰岛素泵的这种作用可得到充分的证实,” Isabelle Steineck说道。

更频繁的监测

研究的下一步将是确定这种作用的发生机制以解释胰岛素泵治疗所带来的额外益处。Dr. Steineck 认为,两种治疗方法产生差异的其中一个原因可能是胰岛素泵的治疗方法通常伴随着更广泛的患者训练以及更频繁的血糖监测。

“胰岛素泵治疗较胰岛素每日多次注射治疗获得更稳定的血糖浓度。既往研究表明,胰岛素泵治疗可减少严重低血糖的发生频率。严重的低血糖是心血管疾病发生的危险因素,尤其是心血疾病高危患者。”

“我们评估了使用胰岛素泵治疗的患者,我们不知道这种效果是由于胰岛素持续灌注所致还是其他一些可强化血糖检测,增强控制血糖的监测或对1型糖尿病更好的了解所致,” Isabelle Steineck说道。

安全有效

研究人总结道,胰岛素泵不仅可使患者的生活变得更加轻松,而且还是了一种安全有效的治疗方法。

“对于1型糖尿病患者来说者无疑是个好的消息,”Soffia Gudbjörnsdottir说道,“但并不是每个患者都想使用胰岛素泵,其首要任务仍是优化血糖监测。”

瑞典约20%的1型糖尿病患者应用了胰岛素泵治疗。但是Sahlgrenska学院早些时期的研究表明,医院内患者接受胰岛素泵治疗的比例差别很大-从12%到30%不等。

原始出处:

Steineck I, Cederholm J, Eliasson B, Rawshani A, Eeg-Olofsson K, Svensson AM, Zethelius B, Avdic T, Landin-Olsson M, Jendle J, Gudbjörnsdóttir S; Swedish National Diabetes Register.Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18 168 people with type 1 diabetes: observational study. BMJ. 2015 Jun 22;350:h3234. doi: 10.1136/bmj.h3234.

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    2016-06-30 gaoxiaoe
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    2015-11-26 baoya
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    2015-08-16 shuaijing1986

    0

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    2015-08-15 dreamslink

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