A Review of Continuous Glucose Monitoring Data Interpretation in the Age of Automated Insulin Delivery.
A Review of Continuous Glucose Monitoring Data Interpretation in the Age of Automated Insulin Delivery.
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DOI：
10.1177/1932296819851790
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发表时间：
2019-07-01
影响因子：
5
通讯作者：
Buckingham, Bruce
中科院分区：
文献类型：
--
作者：
Ekhlaspour, Laya;Tabatabai, Ideen;Buckingham, Bruce
使用动态血糖监测仪（CGM）可改善1型糖尿病患者的血糖控制。建议将动态血糖曲线（AGP）作为报告CGM数据的标准方法。然而，在最近开发的自动胰岛素输送（AID）系统中，尚未开发用于报告数据的标准格式。相反，报告特定于所使用的每个系统。目前，FDA批准的唯一AID系统是混合闭环胰岛素泵。在这些系统中，患者仍然需要宣布用餐，对警报做出响应，并使系统保持自动胰岛素输送。集成的泵和传感器信息提供了对系统如何执行以及如何更改可调参数（例如碳水化合物与胰岛素比率）的见解。这些报告还提供了一个窗口，了解与执行糖尿病任务、响应警报、退出HCL的原因以及如何实现血糖目标有关的人类行为。本文综述了当前几种闭环系统提供的胰岛素泵和CGM数据，重点关注目前在美国获批的系统（MiniMed 670G，Tandem Basal：IQ）和患者使用自助系统使用的系统。一个逐步的方法来审查这些系统的细微差别。这种比较可能会加强继续需要简化标准报告的重要性，以便供应商能够解释这些系统的CGM数据。
Using a continuous glucose monitor (CGM) improves glycemic control in patients with type 1 diabetes. The ambulatory glucose profile (AGP) has been recommended as a standard method for reporting CGM data. However, in recently developed automated insulin delivery (AID) systems, a standard format for reporting data has not yet been developed. Instead, reports are specific to each system being used. Currently, the only FDA approved AID system is a hybrid closed-loop insulin pump. In these systems, the patient is still required to announce a meal, respond to alerts, and keep the system in automated insulin delivery. The integrated pump and sensor information provides insights into how the system is performing, and how to make changes to tunable parameters, such as carbohydrate to insulin ratios. The reports also offer a window into human behavior related to performing diabetes tasks, responding to alarms, reasons for exiting HCL, and how glycemic goals are being met. This article reviews the pump and CGM data provided by several of the current closed-loop systems with a focus on systems that are currently approved in the United States (MiniMed 670G, Tandem Basal:IQ) and those used by patients using do-it-yourself systems. A step-wise approach to reviewing the nuances of these systems is provided. The comparison may reinforce the importance of the continued need for streamlining a standard report for providers to be able to interpret the CGM data of these systems.