Real-time continuous glucose monitoring together with telemedical assistance improves glycemic control and glucose stability in pump-treated patients
Real-time continuous glucose monitoring together with telemedical assistance improves glycemic control and glucose stability in pump-treated patients
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DOI：
10.1089/dia.2007.0273
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发表时间：
2008-06-01
影响因子：
5.4
通讯作者：
de Leiva, Alberto
中科院分区：
文献类型：
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作者：
Rigla, Mercedes;Hernando, M. Elena;de Leiva, Alberto
工作背景：实时连续血糖监测（CGM）最近已被纳入常规糖尿病管理，因为它提供了血糖控制的潜在优势。我们研究的目的是评估使用实时CGM与远程医疗系统一起对接受胰岛素泵治疗的1型糖尿病患者的血红蛋白A1 c和葡萄糖变异性的影响：10例患者（5名女性，41.2 [范围，21-62]岁，糖尿病持续时间14.9 [范围，3-52]年）被纳入这项随机交叉研究。患者在整个研究期间使用DIABTel远程医疗系统，在干预阶段每周使用3天实时CGM。在对照期结束时，进行盲态3天CGM。使用葡萄糖风险指数（GRI），连续两个hours.Results的连续葡萄糖值的比较分析，葡萄糖变异性进行了评估：血红蛋白A1 c显着下降（8.1 +/- 1.1%比7.3 +/- 0.8%; P = 0.007）干预阶段后，而没有变化，在控制阶段观察。在干预阶段，每日毛细血管葡萄糖读数的平均数较高（4.7 +/- 1.1 vs. 3.8 +/- 1.0; P < 0.01），因为随机分析增加（1.22 +/- 0.3 vs. 0.58 +/- 0.1; P < 0.01），并且每天的推注剂量的平均数量也显著增加（5.23 +/- 1.1对4.4 +/- 0.8; P < 0.05）。GRI在对照期高于实验期（9.6 vs.6.25; P < 0.05）。结论：实时CGM结合DIABTel系统可改善泵治疗的1型糖尿病患者的血糖控制和血糖稳定性。
Background: Real-time continuous glucose monitoring (CGM) has recently been incorporated into routine diabetes management because of the potential advantages it offers for glycemic control. The aim of our study was to evaluate the impact of the use of real-time CGM together with a telemedicine system in hemoglobin A1c and glucose variability in patients with type 1 diabetes treated with insulin pumps.Methods: Ten patients (five women, 41.2 [range, 21-62] years old, duration of diabetes 14.9 [range, 3-52] years) were included in this randomized crossover study. Patients used the DIABTel telemedicine system throughout the study, and real-time CGM was used for 3 days every week during the intervention phase. At the end of the control phase, a blind 3-day CGM was performed. Glucose variability was evaluated using the Glucose Risk Index (GRI), a comparative analysis of continuous glucose values over two consecutive hours.Results: Hemoglobin A1c decreased significantly (8.1 +/- 1.1% vs. 7.3 +/- 0.8%; P = 0.007) after the intervention phase, while no changes were observed during the control phase. The mean number of daily capillary glucose readings was higher during the intervention phase (4.7 +/- 1.1 vs. 3.8 +/- 1.0; P < 0.01), because of an increase in random analyses (1.22 +/- 0.3 vs. 0.58 +/- 0.1; P < 0.01), and there was also a significant increase in the mean number of bolus doses per day (5.23 +/- 1.1 vs. 4.4 +/- 0.8; P < 0.05). The GRI was higher during the control phase than during the experimental phase (9.6 vs. 6.25; P < 0.05).Conclusions: Real-time CGM in conjunction with the DIABTel system improves glycemic control and glucose stability in pump-treated patients with type 1 diabetes.