Nighttime hypoglycemia in Japanese children with type 1 diabetes mellitus treated with multiple daily injection insulin therapy
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- Abe Yuki
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Niigata City General Hospital, Niigata 950-1197, Japan
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- Urakami Tatsuhiko
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Nihon University Hospital, Tokyo 101-8309, Japan
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- Suzuki Junichi
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Nihon University Hospital, Tokyo 101-8309, Japan
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- Morita Satoshi
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Kagoshima Seikyo Hospital, Kagoshima 891-0141, Japan
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- Araki Mariko
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Kochi Medical School Hospital, Kochi 783-8505, Japan
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- Mizota Michiyo
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Imamura General Hospital, Kagoshima 890-0064, Japan
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- Sasaki Goro
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Tokyo Dental College, Ichikawa General Hospital, Chiba 272-8513, Japan
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- Mori Jun
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, University Hospital, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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- Tatematsu Toshi
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Chubu Rosai Hospital, Aichi 455-8530, Japan
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- Mine Yusuke
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Nihon University Hospital, Tokyo 101-8309, Japan
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- Yoshida Kei
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Nihon University Hospital, Tokyo 101-8309, Japan
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- Kikuchi Toru
- The Japanese Study Group of Insulin Therapy for Childhood and Adolescent Diabetes, Kyoto 604-0835, Japan Department of Pediatrics, Saitama Medical University Hospital, Saitama 350-0495, Japan
抄録
<p>Prevention of hypoglycemia is an important strategy for glycemic management in patients with type 1 diabetes mellitus (T1D). Hypoglycemia is difficult to recognize at night while sleeping, particularly when using multiple daily injection (MDI) insulin therapy rather than sensor-augmented insulin-pump therapy. Therefore, it is possible that patients with T1D are at higher risk of nocturnal hypoglycemia when insulin is administered using an MDI regimen. We investigated nocturnal hypoglycemia in 50 pediatric patients with T1D on MDI insulin therapy using data from an intermittently scanned continuous glucose monitoring (isCGM) system. Hypoglycemia was observed on 446 of the 1,270 nights studied. Most of the hypoglycemic episodes were severe (blood glucose <54 mg/dL). On nights when hypoglycemia occurred, the blood glucose concentrations measured using finger-stick blood glucose monitoring (FSGM) before sleep and the next morning were lower than nights when hypoglycemia did not occur. However, few values were below the normal blood glucose range, suggesting that FSGM alone may be insufficient to detect nocturnal hypoglycemia. Approximately 7% of time was spent below the normal glucose range during the 10 hours from 21:00 to 7:00 the next morning. This result suggests that the patients on MDI insulin therapy could end up spending more time in hypoglycemia than is recommended by the American Diabetes Association (time below range <4.0% of time per day). Monitoring glucose levels overnight using an isCGM sensor may improve glycemic management via automatic detection of blood glucose peaks and troughs.</p>
収録刊行物
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- Endocrine Journal
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Endocrine Journal 70 (7), 677-685, 2023
一般社団法人 日本内分泌学会