Is the masked continuous glucose monitoring system clinically useful for predicting hemoglobin A1C in type 1 diabetes?
Is the masked continuous glucose monitoring system clinically useful for predicting hemoglobin A1C in type 1 diabetes?
复制标题
隐蔽连续血糖监测系统在临床上对预测 1 型糖尿病患者的血红蛋白 A1C 有用吗？
DOI：
10.1089/dia.2013.0297
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发表时间：
2014
影响因子：
5.4
通讯作者：
Schade,DavidS
中科院分区：
文献类型：
--
作者：
Duran-Valdez,Elizabeth;Burge,MarkR;Broderick,Paula;Shey,Lynda;Valentine,Virginia;Schrader,Ronald;Schade,DavidS
背景：面罩式连续血糖监测系统（mask - cgms）与标准的cgms有三个不同之处：(1)没有反馈给用户，因此不能立即改变方案；(2)最长只能佩戴5天；(3)没有警示高血糖或低血糖的警报器。自2008年以来，由于确定患者的血红蛋白A1C与他或她的毛细血管血糖测量值不密切相关的原因，屏蔽式cgms变得流行起来。迄今为止，只有一项研究发表了掩膜cgms改善糖尿病患者A1C的临床应用。目前还没有专门的研究来检查隐性cgms和A1C的变异性和相关性。研究对象和方法：我们在1型糖尿病患者中进行了156项屏蔽式cgms研究（40例患者按顺序研究，每次最多4次）。然后，我们分析了从屏蔽- cgms中获得的间质葡萄糖水平，并将其与屏蔽- cgms研究后一周内进行的A1C测量进行了比较。结果：糖化血红蛋白与经mask - cgms测定的间质糖水平相关性极低。该统计数据并没有提供足够的预测信息，在临床上对改变个体患者的强化胰岛素治疗方案有用。结论：我们的数据表明，5天的隐蔽性CGMS与同时测量的A1C水平之间存在非常弱的相关性。对于个体1型糖尿病患者，这种关系不太可能在临床上对改变个体的治疗方案有用。
Background:The masked continuous glucose monitoring system (Masked-CGMS) differs from standard CGMSs in three ways: (1) there is no feedback to the user so that no immediate regimen changes can be made; (2) it can only be worn for up to 5 days; and (3) there are no alarms to warn of hyperglycemia or hypoglycemia. Since 2008 masked-CGMS has become popular for identifying reasons that a patient's hemoglobin A1C does not correlate closely with his or her capillary blood glucose measurements. To date only one study addressing the clinical utility of Masked-CGMS for improving A1C in diabetes has been published. No studies are available specifically examining the variability and correlation of Masked-CGMS and A1C.Subjects and Methods:We performed 156 Masked-CGMS studies (40 patients studied sequentially a maximum of four times each) in type 1 diabetes patients. We then analyzed the resulting interstitial glucose levels obtained from the Masked-CGMS compared with an A1C measurement performed within 1 week of the Masked-CGMS study.Results:There was a very low correlation between the A1C and the Masked-CGMS-derived mean interstitial glucose level. This statistic did not provide sufficiently predictive information to be clinically useful for changing an individual patient's intensive insulin therapy regimen.Conclusions:Our data demonstrate that a very weak correlation exists between 5 days of masked CGMS and a concurrently measured A1C level. For the individual type 1 diabetes patient, this relationship would unlikely to be clinically useful in altering the individual's treatment regimen.