アブストラクト
Japanese
| Title | ハイブリッドクローズドループ療法を用いて血糖管理を行った1型糖尿病の1症例 |
|---|---|
| Subtitle | 症例報告 |
| Authors | 久住裕俊1), 大石祐1), 村越大輝1), 平松直樹1) |
| Authors (kana) | |
| Organization | 1)地方独立行政法人静岡県立病院機構静岡県立総合病院検査部検査技術・臨床工学室 |
| Journal | 医学検査 |
| Volume | 72 |
| Number | 1 |
| Page | 135-140 |
| Year/Month | 2023 / 1 |
| Article | 報告 |
| Publisher | 日本臨床衛生検査技師会 |
| Abstract | 「要旨」 1型糖尿病患者におけるCSII・SAP療法は, 個々の必要量に応じた基礎インスリンの調節が可能となるため, 生理的インスリン分泌に近いインスリン投与が行える治療法である. 2022年1月よりRT-CGMより得られたセンサーグルコース値に基づき, 基礎インスリン量を自動調節するテクノロジーであるハイブリッドクローズドループを搭載したインスリンポンプが本邦で認可された. 当院では, インスリンポンプの導入・継続指導を臨床検査技師が担当しており, 今回, HCL療法を用いて血糖管理を行った1型糖尿病の症例を経験したので報告する. 本症例はSAP療法による血糖管理を行っていたが, 仕事の多忙さを理由に血糖補正が充分に出来ておらず, HbA1cが7.7〜8.2%と血糖コントロール不良であった. HCL導入後は, HbA1cが7.0〜7.2%に低下し, 血糖自己測定における血糖値も低下傾向であった. さらに, TIRはHCL導入前で51〜56%であったが, HCL導入後は64〜69%に増加した. HCL療法は低血糖イベントを増やすことなくTIRを増加することができ, 患者のQOL向上や糖尿病性合併症の予防に有効な治療法として期待される. |
| Practice | 医療技術 |
| Keywords | hybrid closed loop(HCL), 1型糖尿病, インスリンポンプ, sensor augmented pump(SAP), time in range(TIR), type 1 diabetes, insulin pump |
English
| Title | A case of type 1 diabetes with glycemic control using hybrid closed-loop therapy |
|---|---|
| Subtitle | Case Report |
| Authors | Hirotoshi KUZUMI1), Yuu OISHI1), Daiki MURAKOSHI1), Naoki HIRAMATSU1) |
| Authors (kana) | |
| Organization | 1)Department of Clinical Laboratory and Clinical Engineering, Department of Clinical Laboratory Medicine, Shizuoka General Hospital, Shizuoka Prefectural Hospital Organization |
| Journal | Japanese Journal of Medical Technology |
| Volume | 72 |
| Number | 1 |
| Page | 135-140 |
| Year/Month | 2023 / 1 |
| Article | Report |
| Publisher | Japanese Association of Medical Technologists |
| Abstract | [Summary] Continuous subcutaneous insulin infusion (CSII) and sensor-augmented pump (SAP) therapy in patients with type 1 diabetes are close to physiological insulin secretion because they can regulate basal insulin according to the amount of individual insulin. In January 2022, insulin pumps equipped with a hybrid closed-looped (HCL) system were made available in Japan. HCL therapy is a technology with which the amount of basal insulin can be automatically adjusted on the basis of glucose levels obtained from continuous glucose monitoring (CGM) using a glucose sensor. At our hospital, a clinical laboratory technician is in charge of the introduction and guidance on the use of continuous insulin pumps. We report a case of type 1 diabetes in which blood glucose level was controlled using HCL therapy. Glycemic control with SAP therapy resulted in HbA1c levels of 7.7-8.2%. After the introduction of HCL therapy, HbA1c levels decreased to 7.0-7.2%, and blood glucose levels tended to decrease. Furthermore, time in range (TIR) increased from 51-56% with SAP therapy to 64-69% with HCL therapy. HCL therapy can increase TIR without promoting hypoglycemic events and is effective for improving patient quality of life and preventing diabetic complications. |
| Practice | Medical technology |
| Keywords | hybrid closed loop, type 1 diabetes, insulin pump, sensor augmented pump, time in range |
- 全文ダウンロード： 従量制、基本料金制の方共に770円(税込) です。
参考文献
- 1) Matsuoka A et al.: Effect of switching from conventional continuous subcutaneous insulin infusion to sensor augmented pump therapy on glycemic profile in Japanese patients with type 1 diabetes. Diabetol Int, 2018 ; 9 : 201-207.
- 2) Deiss D et al.: Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care, 2006 ; 29 : 2730-2732.
- 3) Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group : Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med, 2008 ; 359 : 1464-1476.
- 4) 小林 哲郎, 他 : 日本先進糖尿病治療研究会によるCSIIおよびCGMに関するステートメント. 糖尿病, 2014 ; 57 : 403-415.
- 5) Kanda Y : Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant, 2013 ; 48 : 452-458.
残りの6件を表示する
- 6) Battelino T et al : Clinical targets for continuous glucose monitoring data interpretation : Recommendations from the international consensus on time in range. Diabetes Care, 2019 ; 42 : 1593-1603.
- 7) Buckingham BA et al.: Precistive low-glucose insulin suspension reduces duration of nocturnal hypoglycemia in children without increasing ketosis. Diabetes Care, 2015 ; 38 : 1197-1204.
- 8) Calhoun PM et al.: Efficacy of an overnight predictive low-glucose suspend system in relation to hypoglycemia risk factors in youth and adults with type 1 diabetes. J Diabetes Sci Technol, 2016 ; 10 : 1216-1221.
- 9) Garg SK et al.: Glucose outcomes with the in-home use of a hybrid closed-loop insulin delivery system in adolescents and adults with type 1 diabetes. Diabetes Technol Ther, 2017 ; 19 : 155-163.
- 10) Beck RW et al.: Validation of time in range as an outcome measure for diabetes clinical trials. Diabetes Care, 2019 ; 42 : 400-405.
- 11) Lu J et al.: Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes. Diabetes Care, 2018 ; 41 : 2370-2376.
