Continuous Flash Glucose Monitoring in children with Congenital Hyperinsulinism; first report on accuracy and patient experience
Continuous Flash Glucose Monitoring in children with Congenital Hyperinsulinism; first report on accuracy and patient experience
复制标题
先天性高胰岛素血症儿童的连续快速血糖监测；
DOI：
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
S. Senniappan
中科院分区：
文献类型：
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作者：
H. Alsaffar;L. Turner;Zoe Yung;M. Didi;S. Senniappan
背景工厂校准的FreeStyle Libre（FSL）闪光血糖监测系统最近被引入用于糖尿病患者。尚无关于其在先天性高胰岛素血症（CHI）患者中使用的报告。我们已经评估了FSL的准确性相比，手指针刺毛细血管血糖（CBG）在2周内的CHI患者和评估的父母的经验，使用FSL. MethodsFourhundy 67集CBG沿着与相应的刷卡FSL读数可从11名儿童CHI（0.5-5年）。一个详细的问卷调查完成了由parents.ResultsThe两种方法之间的平均变异为0.29 mmol/l（SD ±1.07），更高的读数FSL相比，CBG。FSL传感器在原位停留的平均时间为11.5天。两种方法之间呈正相关（r = 0.7）。与CBG相比，FSL倾向于高估（偏倚= 0.29 mmol/l; 95% CI：0.19 - 0.38）。当葡萄糖浓度低于5.6 mmol/l时，仅70%的值在参比标准品（±0.83 mmol/l）范围内。总体平均绝对相对差异（MARD）为17.9%。观察到42次低血糖发作（CBG < 3.5 mmol/l），但FSL仅识别出52%的低血糖发作。Bland Altman分析显示，两种方法之间的95%一致性限度范围为-1.8（95%CI：-1.97至-1.64）至2.37（95%CI：2.21至2.54）。大多数父母发现FSL的血糖趋势有助于检测和预防低血糖发作。所有的父母都认为FSL是一种非常简单方便的方法来测量葡萄糖，特别是在睡眠期间。一个显着比例的家长认为，FSL读数不准确，56%的家长表示有兴趣继续使用FSL后，审判period.ConclusionNoticeable变异测量葡萄糖的两种方法之间的注意。尽管FSL系统易于使用，但仍存在与准确性相关的问题，特别是在低血糖值时，尽管父母发现血糖趋势非常有用。在推荐FSL作为测量血糖水平的常规替代方法之前，还需要在CHI患者中进行更大规模的试验。
BackgroundThe factory calibrated FreeStyle Libre (FSL) flash glucose monitoring system has been recently introduced for use in patients with diabetes mellitus. There are no reports available regarding its use in patients with congenital hyperinsulinism (CHI). We have assessed the accuracy of FSL compared to the finger prick capillary blood glucose (CBG) over 2 weeks period in patients with CHI and evaluated the parents’ experience of using FSL.MethodsFour hundred sixty-seven episodes of CBG along with corresponding swipe FSL readings were available from 11 children with CHI (0.5–5 years). A detailed questionnaire was completed by the parents.ResultsThe mean variation between the two methods was 0.29 mmol/l (SD ±1.07), higher readings by FSL compared to CBG. The FSL sensors stayed in-situ for an average period of 11.5 days. There was a positive correlation between the two methods (r = 0.7). The FSL tended to overestimate compared to CBG (bias = 0.29 mmol/l; 95% CI: 0.19 to 0.38). Only 70% of values were within the reference standard (±0.83 mmol/l) at glucose concentrations less than 5.6 mmol/l. The overall Mean Absolute Relative Difference (MARD) was 17.9%. Forty two episodes of hypoglycaemia (CBG < 3.5 mmol/l) were noted but FSL identified only 52% of these episodes. The Bland Altman analysis showed the 95% limits of agreement between the two methods ranging from − 1.8 (95% CI: -1.97 to − 1.64) to 2.37 (95% CI: 2.21 to 2.54). Majority of the parents found the glucose trend on FSL to be useful to detect and prevent hypoglycaemic episodes. All parents felt that FSL is a very easy and convenient method to measure the glucose especially during sleep. A significant proportion of parents felt that FSL readings were not accurate and 56% of parents expressed interest to continue using FSL after the trial period.ConclusionNoticeable variability between the two methods of measuring the glucose was noted. Despite the ease of using the FSL system, concerns related to accuracy, especially at low glucose values do remain although parents find the glucose trend to be very useful. Further larger trials are needed in CHI patients before FSL is recommended as a routine alternative method for measuring glucose levels.
影响因子：
158.5
作者：
Bergenstal, Richard M.;Tamborlane, William V.;Wood, Michael A.
通讯作者：
Wood, Michael A.
影响因子：
16.2
作者：
Monsod, TP;Flanagan, DE;Tamborlane, WV
通讯作者：
Tamborlane, WV