Clinical relevance of glucose patterns in older adults

摘要 糖代谢紊乱和血糖不稳定在老年人中很常见。年龄是最大的 2型糖尿病发展的重要危险因素，越来越多的证据表明血糖升高 变异性会增加并发症的风险，与平均血糖或糖化血红蛋白无关。在患有 对于糖尿病，对于合适的治疗目标存在争议，低血糖是一个主要问题。 连续血糖监测(CGM)是评估低血糖和 血糖变异性，但这项技术很少用于老年人。高龄成年人(80岁或以上 老年人)是一个特别脆弱的群体，但很少包括在以前的研究中。我们最重要的是 目的是使用最先进的CGM技术来表征老年人(&gt；80岁)的血糖模式。 我们将描述“正常”的血糖模式，并评估未被识别的血糖升高的频率 患有和不患有糖尿病的成年人(包括糖尿病前期患者)的短途旅行。我们会将葡萄糖 包括血糖漂移(低血糖和高血糖)到当前健康状态和临床结果的模式 在4年的随访期内。这些结果将为血糖模式的临床相关性提供信息。 并产生关于使用和解释的循证指导 这群人中的CGM。

Abstract Disordered glucose homeostasis and glucose instability are common in older adults. Age is one of the most important risk factors for the development of type 2 diabetes and there is growing evidence that glycemic variability contributes to risk of complications, independent of average glucose or HbA1c. In older adults with diabetes, there is controversy regarding appropriate treatment targets and hypoglycemia is a major concern. Continuous glucose monitoring (CGM) is the recommended approach to the assessment of hypoglycemia and glycemic variability, but this technology has rarely been used in older adults. Very old adults (age 80 years or older) are a particularly vulnerable population but have rarely been included in prior studies. Our overarching objective is to characterize glucose patterns in older adults (>80 years) using state-of-the-art CGM technology. We will characterize “normal” glucose patterns and evaluate the frequency of unrecognized glycemic excursions in adults with and without diabetes (including persons with prediabetes). We will relate glucose patterns including glucose excursions (hypo- and hyperglycemia) to current health status and clinical outcomes during 4 years of follow-up. These results will provide information on the clinical relevance of glucose patterns in an older adult population and generate evidence-based guidance regarding the use and interpretation of CGM in this population.