Remote glucose monitoring is feasible for patients and providers using a commercially available population health platform.
Remote glucose monitoring is feasible for patients and providers using a commercially available population health platform.
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DOI：
10.3389/fendo.2023.1063290
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发表时间：
2023
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
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远程患者监测 (RPM) 有望为 1 型糖尿病 (T1D) 患者提供更加个性化和有效的护理，但需要进行群体分析，将有限的临床资源集中在最需要的患者身上。我们使用商用数据分析平台（glooko Population Health）在一群患有 T1D 的年轻人中，从患者和提供者的角度探讨了 RPM 的可行性。招募年龄为 1-20 岁、已确诊 T1D（≥12 个月）和使用 CGM（≥3 个月）的患者参与。在一个月的基线期间，参与者的 CGM 设备连接到 glooko 应用程序并链接到研究团队的 glooko 帐户。接下来是为期六个月的干预期，在此期间，每月>15%的血糖值>250 mg/dl或>5%的血糖值<70 mg/dl的参与者会获得个性化的糖尿病管理建议。对参与者的经历进行了调查，并通过基线和完成时 CGM 数据生成的血糖管理指标 (GMI) 的变化来估计对血糖控制的影响。还评估了不同血糖范围内花费的时间的变化，并通过双重差分回归将所有血糖指标与非随机对照组进行比较，调整基线特征。 39 名参与者中有 36 名 (92%) 成功实现了远程数据共享。 33%-66% 的参与者每月值得进行外展活动，而临床医生外展活动平均每次活动需要 10 分钟。据报道，94% 的参与者认为 RPM 有帮助。对于整个队列，RPM 与 -0.25%（P=0.047）的 GMI 变化相关，分层分析显示基线 GMI 为 8.0-9.4% 的参与者治疗效果最大（GMI 变化为 -0.68%，P=0.047；花费>250 mg/dl 的时间减少 19.84%，P=0.005）。这项研究证明了使用市售人口健康平台对 T1D 患者进行 RPM 的可行性，并表明由临床医生发起的 RPM 可能对入院时血糖控制不佳的患者特别有益。然而，需要更大规模的随机研究来充分探讨 RPM 对血糖的影响。 ，标识符 NCT04696640。
Remote patient monitoring (RPM) holds potential to enable more individualized and effective care for patients with type 1 diabetes (T1D), but requires population analytics to focus limited clinical resources on patients most in need. We explored the feasibility of RPM from patient and provider standpoints using a commercially available data analytic platform (glooko Population Health) among a cohort of youth with T1D. Patients aged 1-20 years with established T1D (≥12 months) and CGM use (≥3 months) were recruited to participate. Participants’ CGM devices were connected to the glooko app and linked to the research team’s glooko account during a one-month baseline period. This was followed by a six-month intervention period during which participants with >15% of glucose values >250 mg/dl or >5% of values <70 mg/dl each month were contacted with personalized diabetes management recommendations. Participants were surveyed about their experiences, and effects on glycemic control were estimated via change in glucose management indicator (GMI) generated from CGM data at baseline and completion. Changes in time spent within various glucose ranges were also evaluated, and all glycemic metrics were compared to a non-randomized control group via difference-in-difference regression, adjusting for baseline characteristics. Remote data-sharing was successful for 36 of 39 participants (92%). Between 33%-66% of participants merited outreach each month, and clinician outreach required a median of 10 minutes per event. RPM was reported to be helpful by 94% of participants. RPM was associated with a GMI change of -0.25% (P=0.047) for the entire cohort, and stratified analysis revealed greatest treatment effects among participants with baseline GMI of 8.0-9.4% (GMI change of -0.68%, P=0.047; 19.84% reduction in time spent >250 mg/dl, P=0.005). This study demonstrates the feasibility of RPM for patients with T1D using a commercially available population health platform, and suggests that RPM with clinician-initiated outreach may be particularly beneficial for patients with suboptimal glycemic control at entry. However, larger randomized studies are needed to fully explore the glycemic impact of RPM. , identifier NCT04696640.
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影响因子：
4.1
作者：
Walker AF;Cuttriss N;Haller MJ;Hood KK;Gurka MJ;Filipp SL;Anez-Zabala C;Yabut K;Roque X;Wong JJ;Baer L;Figg L;Bernier A;Westen S;Lewit E;Sheehan E;Basina M;Lal R;Maizel J;Maahs DM
通讯作者：
Maahs DM
影响因子：
16.2
作者：
Bergenstal RM;Beck RW;Close KL;Grunberger G;Sacks DB;Kowalski A;Brown AS;Heinemann L;Aleppo G;Ryan DB;Riddlesworth TD;Cefalu WT
通讯作者：
Cefalu WT
影响因子：
3.4
作者：
Ferstad JO;Vallon JJ;Jun D;Gu A;Vitko A;Morales DP;Leverenz J;Lee MY;Leverenz B;Vasilakis C;Osmanlliu E;Prahalad P;Maahs DM;Johari R;Scheinker D
通讯作者：
Scheinker D
影响因子：
16.2
作者：
Battelino, Tadej;Danne, Thomas;Phillip, Moshe
通讯作者：
Phillip, Moshe
影响因子：
9.7
作者：
Seshamani, Meena
通讯作者：
Seshamani, Meena