Continuous Glucose Monitoring Pilot in Low-Income Type 1 Diabetes Patients
Continuous Glucose Monitoring Pilot in Low-Income Type 1 Diabetes Patients
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DOI：
10.1089/dia.2013.0072
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发表时间：
2013-10-01
影响因子：
5.4
通讯作者：
Peters, Anne L.
中科院分区：
文献类型：
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作者：
Sequeira, Paola A.;Montoya, Lucy;Peters, Anne L.
背景：动态血糖监测（CGM）已被证明是改善糖尿病患者血糖控制的有价值的工具。这项试点研究的目的是开发和实施CGM在现有的糖尿病诊所为低收入患者的多次每日injections.Subjects和方法：这是一个单中心，前瞻性，随机对照，交叉试点研究。举行了初步的重点小组会议，以编写低识字率、西班牙语和英语的碳水化合物计数和CGM使用指南。实施这些工具以培训参与者碳水化合物计数和胰岛素调整参与者。然后将受试者随机分配至A组（CGM）或B组（自我监测血糖，然后在28周后转换）。血红蛋白A1C（HbA1C）获得在基线和研究phase.Results结束时：二十五个经济上的挑战，主要是拉丁美洲参与者与最低限度的强化糖尿病管理的教育完成了研究。未显示HbA1c显著降低或低血糖和高血糖参数所用时间减少。然而，80%完成研究的参与者希望在研究结束后继续使用CGM。与会者还认为，CGM调整胰岛素easily.Conclusions：CGM可以在低收入的公共诊所的患者实施，但是，HbA1c降低没有实现。由于缺乏基本的自我管理知识，可能需要更长的试验来观察CGM在该人群中的获益。
Background: Continuous glucose monitoring (CGM) has been shown to be a valuable tool to improve glycemic control in patients with diabetes. The objective of this pilot study was to develop and implement CGM in an existing diabetes clinic for low-income patients on multiple daily injections.Subjects and Methods: This was a single-center, prospective, randomized controlled, crossover pilot study. Initial focus groups were held to create low-literacy, Spanish and English guides to the use of carbohydrate counting and CGM. These tools were implemented to train participants on carbohydrate counting and insulin adjustments participants. Subjects were then randomized to start in Group A (CGM) or Group B (self-monitoring blood glucose and then switched after 28 weeks). Hemoglobin A1c (HbA1c) was obtained at baseline and at the end of both study phases.Results: Twenty-five economically challenged, primarily Latino participants with minimal prior education on intensive diabetes management completed the study. No significant reduction in HbA1c or decrease in time spent in parameters of low and high blood glucose was shown. However, eighty percent of participants who completed the study wanted to continue to use CGM once the research study was over. The participants also felt that the CGM made adjusting insulin easier.Conclusions: CGM can be implemented in patients from a low-income public clinic; however, HbA1c reduction was not achieved. Given the underlying lack of baseline self-management knowledge, a longer trial might be necessary to see benefit with CGM in this population.