De Block Christophe, Vertommen Jan, Manuel-y-Keenoy Begoña, Van Gaal Luc
Department of Endocrinology-Diabetology, Antwerp University Hospital (UZA), Wilrijkstraat 10, B-2650 Edegem, Belgium.
Curr Diabetes Rev. 2008 Aug;4(3):159-68. doi: 10.2174/157339908785294415.
Accurate and reliable devices sensing glucose on a (near)-continuous basis may facilitate specific therapeutic adjustments that need to be made to avoid hypo- and hyperglycaemic excursions, thereby improving metabolic control. Current continuous glucose monitoring (CGM) systems indicate the glucose level, the direction and magnitude of change of glucose levels, and can be used to assess glycaemic variability. In addition, real-time CGM sensors can serve as a tool to predict impending glucose excursions, thereby providing alarm signals of hypo- and hyperglycaemic values warning the patient to take preventative actions. Quality of life may also improve by using CGM via reducing the fear of hypoglycaemia. Particularly patients with brittle diabetes, hypoglycaemia unawareness, gastroparesis, pregnant women, or pump users, who are motivated to participate in their diabetes care and are technologically adept, may benefit from CGM. However, to successfully implement CGM in daily practice, these devices must be accurate and reliable, and one must be aware of the limitations of current CGM systems, that originate from physiological and technical aspects. Whether CGM succeeds in improving metabolic control, reducing hypoglycaemic episodes, and improving quality of life in the majority of patients remains to be proven. Should this be the case, real-time CGM may reduce chronic diabetic complications, and avoid hospitalisations, thereby reducing health care costs. In this article we will review indications, advantages, limitations, clinical and technical aspects of current minimally-invasive and non-invasive CGM sensors.
能够（近乎）持续准确可靠地检测葡萄糖的设备，可能有助于进行特定的治疗调整，以避免低血糖和高血糖波动，从而改善代谢控制。当前的连续血糖监测（CGM）系统可显示血糖水平、血糖水平变化的方向和幅度，并可用于评估血糖变异性。此外，实时CGM传感器可作为预测即将发生的血糖波动的工具，从而提供低血糖和高血糖值的警报信号，提醒患者采取预防措施。通过使用CGM减少对低血糖的恐惧，生活质量也可能得到改善。特别是脆性糖尿病患者、低血糖无意识患者、胃轻瘫患者、孕妇或胰岛素泵使用者，他们有积极性参与糖尿病护理且技术熟练，可能会从CGM中受益。然而，要在日常实践中成功应用CGM，这些设备必须准确可靠，而且必须意识到当前CGM系统源于生理和技术方面的局限性。CGM能否成功改善大多数患者的代谢控制、减少低血糖发作并提高生活质量仍有待证实。如果真是这样，实时CGM可能会减少慢性糖尿病并发症，避免住院治疗，从而降低医疗成本。在本文中，我们将综述当前微创和无创CGM传感器的适应症、优点、局限性、临床和技术方面。
