Low-Dose Glucagon to Prevent and Treat Exercise-Associated Hypoglycemia in Individuals With Type 1 Diabetes: A Systematic Review and Meta-analysis.

research_design_and_methods

This systematic reviewand meta-analysisevaluated low-dose glucagon's efficacy for preventing and treating exercise-induced hypoglycemia in T1D.

本系统评价和荟萃分析评估了低剂量胰高血糖素预防和治疗1型糖尿病（T1D）患者运动引起的低血糖的疗效。

Medline, Embase, and Cochrane CENTRAL were searched for randomized controlled trials and crossover studies until September 2024.

检索了 Medline、Embase 和 Cochrane CENTRAL，直至 2024 年 9 月，以寻找随机对照试验和交叉研究。

The analysis included T1D adolescents and adults treated with low-dose glucagon versus nonglucagon treatments.

分析纳入了接受低剂量胰高血糖素治疗与非胰高血糖素治疗的 1 型糖尿病青少年和成人。

Studies with glucagon-like peptides, noninsulin combinations, or uncontrolled exercise settings were excluded.

排除了研究胰高血糖素样肽、非胰岛素组合或不受控制的运动设置的研究。

Two authors extracted the data.

两位作者提取了数据。

The methodological quality was assessed with the Risk of Bias-2 tool and Grading of Recommendations Assessment, Development and Evaluations framework.

使用风险偏倚-2工具和推荐分级评估、制定与评价框架评估了方法学质量。

Risk of Bias 2 informed a sensitivity analysis.

风险偏倚2指导了一项敏感性分析。

The meta-analysisemployed a random effects model to estimate the pooled treatment effects on hypoglycemia and time below range (TBR) (glucose <3.9 mmol/L), as well as secondary outcomes and adverse effects.

该荟萃分析采用随机效应模型估计低血糖和低于范围时间（TBR）（血糖<3.9 mmol/L）的汇总治疗效果，以及次要结果和不良反应。

Results

Of 6,792 records, 12 studies involving 248 individuals (mean age: 36 ± 10.5 years) met inclusion criteria.

在6,792条记录中，有12项研究涉及248名个体（平均年龄：36 ± 10.5岁）符合纳入标准。

The meta-analysisshowed significant reductions in hypoglycemia risk (risk ratio 0.54; 95% CI 0.35, 0.84) and TBR (-3.91 percentage points; 95% CI -6.27, 1.54) with low-dose glucagon.

元分析显示低剂量胰高血糖素可显著降低低血糖风险（风险比0.54；95%置信区间0.35, 0.84）和TBR（-3.91个百分点；95%置信区间-6.27, 1.54）。

Sensitivity analysis yielded a slightly more confident effect size for hypoglycemia and TBR.

敏感性分析得出对低血糖和TBR的效应大小有稍微更自信的结果。

However, overall adverse events increased with low-dose glucagon (risk ratio 2.75; 95% CI 1.07, 7.08).

然而，低剂量胰高血糖素治疗的总体不良事件有所增加（风险比 2.75；95% 置信区间 1.07, 7.08）。

The included studies were few and heterogeneous, which may have influenced the overall outcomes.

纳入的研究数量较少且异质性较大，这可能影响了总体结果。

Conclusions

Low-dose glucagon reduces exercise-induced hypoglycemia and TBR in T1D individuals.

低剂量胰高血糖素可减少1型糖尿病患者运动引起的低血糖和TBR（目标血糖比值）事件。

Future research should optimize glucagon dosage and timing for various exercise types and durations to confirm real-world effectiveness.

未来的研究应优化不同运动类型和持续时间下的胰高血糖素剂量和给药时机，以确认其在实际应用中的有效性。