Maia Frederico F R, Araújo Levimar R
Serviço de Clínica Médica e Clínica de Endocrinologia e Metabologia, Hospital Universitário São José, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG.
Arq Bras Endocrinol Metabol. 2005 Aug;49(4):563-8. doi: 10.1590/s0004-27302005000400015. Epub 2005 Oct 19.
To evaluate the efficacy, safety and complications of continuous glucose monitoring system (CGMS) in type 1 diabetic patients (DM1), we retrospectively studied 30 patients (25.8 +/- 12.2 years) submitted to 72 hs CGMS (Medtronic; Northridge, CA) and analyzed: mean self monitoring blood glucose (SMBG) and mean CGMS sensors glycemic value; correlation coefficient (%), median absolute percent difference (MAD%), number of sensor reading, glycemic excursions (CGMS vs. SMBG), complications (trauma, local infection, disconnection) and therapeutic management after CGMS. A1c levels were measured 1 month before and 3 months after the study. Mean capillary glucose values were 186.5 +/- 43.3 mg/dl vs. 179.7 +/- 48.1 mg/dl by CGMS sensor, with significant correlation (p = 0.001). An average of 772.4 +/- 254.1 (VR > 680) glucose measurements was recorded for each patient, with 68.7 +/- 19.8 hs of exam. Correlation coefficient was 0.86 +/- 0.21 (VR > 0.79). Median absolute percent difference between sensor and glucometer values was 13.9 +/- 4.7% (VR < 28%). The CGMS was significant more efficient in detection of glycemic excursion related to capillary glycemia (p = 0.009). This data showed important decreased level of A1c in this population 3 months after the CGMS with statistical significance (p = 0.018). No complications were registered in 96.7% of patients. No trauma, local infection or bleeding were registered. The insulin therapeutic regimen was adjusted in 100% of patients. The CGMS showed to be a very safety method, well tolerated, with high accuracy in glycemic values and low complications rate. This method has to be more stimulated by physicians and patients.
为评估持续葡萄糖监测系统（CGMS）在1型糖尿病患者（DM1）中的疗效、安全性及并发症，我们回顾性研究了30例患者（25.8±12.2岁），这些患者接受了72小时的CGMS（美敦力公司；加利福尼亚州诺斯里奇）监测，并分析了：平均自我监测血糖（SMBG）和平均CGMS传感器血糖值；相关系数（%）、中位数绝对百分比差异（MAD%）、传感器读数数量、血糖波动（CGMS与SMBG对比）、并发症（创伤、局部感染、断开连接）以及CGMS后的治疗管理。在研究前1个月和研究后3个月测量糖化血红蛋白（A1c）水平。平均毛细血管血糖值为186.5±43.3mg/dl，而CGMS传感器测量值为179.7±48.1mg/dl，二者具有显著相关性（p = 0.001）。每位患者平均记录了772.4±254.1次（VR>680）血糖测量值，检查时长为68.7±19.8小时。相关系数为0.86±0.21（VR>0.79）。传感器与血糖仪值之间的中位数绝对百分比差异为13.9±4.7%（VR<28%）。CGMS在检测与毛细血管血糖相关的血糖波动方面显著更有效（p = 0.009）。该数据显示，在CGMS实施3个月后，该人群的A1c水平显著降低，具有统计学意义（p = 0.018）。96.7%的患者未出现并发症。未记录到创伤、局部感染或出血情况。100%的患者调整了胰岛素治疗方案。CGMS显示出是一种非常安全的方法，耐受性良好，血糖值准确性高，并发症发生率低。这种方法需要医生和患者更多地采用。
