Continuous Glucose Monitoring in 2015
Continuous Glucose Monitoring in 2015
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DOI：
10.1089/dia.2016.2502
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发表时间：
2016-02-01
影响因子：
5.4
通讯作者：
Bode, Bruce W.
中科院分区：
文献类型：
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作者：
Battelino, Tadej;Bode, Bruce W.
AimsTo评估连续葡萄糖监测，有或没有报警功能，通过比较它的自我监测血糖胰岛素治疗的个人与diabetes.MethodsA共160例T1 D或T2 D患者，对多个每日胰岛素注射或连续皮下胰岛素输注，在100天，随机对照研究在四个欧洲中心进行。在设盲20天后，通过排列区组随机化将受试者随机分配至血糖自我监测（SMBG）（n= 48）、无报警CGM（n= 48）或有报警CGM（n= 49）。两个CGM组均使用FreeStyle Navigator动态葡萄糖监测系统（Abbott Diabetes Care，Mauritiad，UK）。主要结局是血糖目标值3.9-10.0 mmol/L以外的时间差异（70-180 mg/dL）在第80-100天的SMBG对照组相比，CGM无报警group.ResultsTime花费在血糖目标以外的SMBG组为10.6小时/天，CGM无报警组为9.9小时/天，报警CGM组为9.7小时/天（无显著性，与无报警和有报警CGM相比，P= 0.18和0.08）。与SMBG组（分别为1.0 h/天和1.6 h/天; 95% CI− 1.2至− 0.1; P= 0.030）相比，带报警的CGM组发生低血糖（< 3.9 mmol/L [< 70 mg/dL]）的时间更短。在接受持续皮下胰岛素输注（CSII）治疗的患者中，当比较无报警CGM和SMBG（− 1.9 h/d; 95% CI− 3.8至0.0; P= 0.0461）以及当比较有报警CGM和SMBG（− 2.4 h/d; 95% CI− 4.1至− 0.5; P= 0.0134）时，超出血糖目标的时间存在显著差异。三组中A1 c较基线的降低无差异，平均差异约为3 mmol/mol（0.1%）;但是，在此情况下，降低≥ 6 mmol/mol的受试者比例无报警的连续血糖监测组（27%）和有报警的连续血糖监测组（25%）的血糖水平（≥ 0.5%）无显著性高于自我监测组（25%）。血糖监测组（10.6%）。结论：与SMBG相比，CGM的使用减少了在血糖目标之外花费的时间，特别是在胰岛素泵用户和低血糖范围内。
AimsTo evaluate continuous glucose monitoring, with or without an alarm function, by comparing it to self-monitoring of blood glucose in insulin-treated individuals with diabetes.MethodsA total of 160 patients with T1D or T2D, on multiple daily insulin injections or continuous subcutaneous insulin infusion, were enrolled in a 100-day, randomized controlled study conducted at four European centers. Participants were randomized after a masked 20-day period by permuted block randomization to self-monitoring of blood glucose (SMBG)(n= 48), CGM without alarms (n= 48), or CGM with alarms (n= 49). Both CGM groups used FreeStyle Navigator Continuous Glucose Monitoring System device (Abbott Diabetes Care, Maidenhead, UK). The primary outcome was the difference in time spent outside a glucose target of 3.9–10.0 mmol/L (70–180 mg/dL) during days 80–100 in the SMBG control group as compared to CGM without alarms group.ResultsTime spent outside the glucose target was 10.6 h/day for the SMBG group, 9.9 h/day for the CGM without alarms group, and 9.7 h/day for the CGM with alarms group (nonsignificant, P= 0.18 and 0.08 compared with CGM without and with alarms, respectively). The CGM with alarms group spent less time in hypoglycemia (< 3.9 mmol/L [< 70 mg/dL]) compared with the SMBG group (1.0 h/day and 1.6 h/day, respectively; 95% CI− 1.2 to− 0.1; P= 0.030). Among those treated with continuous subcutaneous insulin infusion (CSII), time spent outside the glucose target was significantly different when comparing CGM without alarms and SMBG (− 1.9 h/day; 95% CI− 3.8 to 0.0; P= 0.0461) and when comparing CGM with alarms and SMBG (− 2.4 h/day; 95% CI− 4.1 to− 0.5; P= 0.0134). There was no difference in A1c reduction from baseline in the three groups, with the average difference of around 3 mmol/mol (0.1%); however, the proportion of participants with a reduction of≥ 6 mmol/mol (≥ 0.5%) was nonsignificantly higher in the continuous glucose monitoring without alarms (27%) and continuous glucose monitoring with alarms groups (25%) than in the self-monitoring of blood glucose group (10.6%).ConclusionsThe use of CGM reduces time spent outside glucose targets compared with SMBG, especially among users of insulin pumps and in the hypoglycemic range.