Clinical relevance of glucose patterns in older adults

摘要 葡萄糖稳态紊乱和葡萄糖不稳定在老年人中很常见。年龄是最重要的 2型糖尿病的发生发展的重要危险因素，越来越多的证据表明， 变异性导致并发症风险，与平均血糖或HbA1c无关。在老年人中， 对于糖尿病，关于适当的治疗目标存在争议，并且低血糖是主要关注点。 动态血糖监测（CGM）是评估低血糖的推荐方法， 血糖变异性，但这项技术很少用于老年人。非常老的成年人（80岁或 老年人是一个特别脆弱的群体，但很少被纳入以前的研究。我们的总体 目的是使用最先进的CGM技术表征老年人（>80岁）的葡萄糖模式。 我们将描述“正常”的血糖模式，并评估未识别的血糖变化的频率。 有糖尿病和无糖尿病的成年人（包括前驱糖尿病患者）的旅行。我们将葡萄糖 包括血糖波动（低血糖和高血糖）与当前健康状况和临床结局的模式 在4年的随访中。这些结果将提供有关血糖模式的临床相关性的信息 在老年人群中，并就使用和解释 在这个人群中，

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.