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家用条件下连续血糖监测系统的评估

Evaluation of a continuous glucose monitoring system for home-use conditions.

作者信息

Bode Bruce, Silver Michael, Weiss Richard, Martin Kathryn

机构信息

Atlanta Diabetes Associates, USA.

出版信息

Manag Care. 2008 Aug;17(8):40-5.

PMID:18777789
Abstract

OBJECTIVE

To evaluate the safety and effectiveness of the FreeStyle Navigator Continuous Glucose Monitoring System when used by adult patients with type 1 or 2 diabetes requiring insulin in the home environment.

RESEARCH DESIGN AND METHODS

Multicenter, prospective study enrolling 137 subjects. This was a two-phase study consisting of 20 days of use ("masked period") without access to continuous glucose readings followed by 21 days of use ("unmasked period") with access to continuous glucose readings and glucose alarms. At the conclusion of the study, all subjects were asked to complete a User's Questionnaire.

RESULTS

A total of 11,487 paired continuous glucose sensor and blood glucose reference results from 961 sensors were evaluated; 77.2 percent were in Clarke error grid zone A and 19.6 percent were in zone B. Only 13.1 percent of the hypoglycemic and 0.5 percent of the hyperglycemic threshold alarms were false alerts. Subjects with type 1 diabetes demonstrated a 55 percent reduction in time spent with significant hypoglycemia (below 55 mg/dL) (P < .0001) from masked to unmasked periods. Their average number of hypoglycemic episodes (below 70 mg/dL) per day fell from 1.1 to 0.8 (P < .0001). Results from patient questionnaires demonstrated high levels of subject satisfaction and the ability to use and understand the system.

CONCLUSIONS

FreeStyle Navigator Continuous Glucose Monitoring System is safe and effective, and results in a high level of subject satisfaction while used in the home setting. Utilization of continuous glucose monitors with alerts may result in cost offsets by reducing the number and severity of clinically significant events and assisting in the maintenance of optimal glycemic control.

摘要

目的

评估在家庭环境中,Freestyle Navigator连续血糖监测系统用于需要胰岛素治疗的1型或2型糖尿病成年患者时的安全性和有效性。

研究设计与方法

一项多中心前瞻性研究,招募了137名受试者。这是一项两阶段研究,包括20天的使用期(“遮蔽期”),在此期间无法获取连续血糖读数,随后是21天的使用期(“非遮蔽期”),在此期间可以获取连续血糖读数和血糖警报。在研究结束时,要求所有受试者完成一份用户问卷。

结果

共评估了来自961个传感器的11487对连续血糖传感器和血糖参考结果;77.2%处于克拉克误差网格A区,19.6%处于B区。低血糖阈值警报中只有13.1%为误报,高血糖阈值警报中只有0.5%为误报。1型糖尿病患者从遮蔽期到非遮蔽期,严重低血糖(低于55mg/dL)的时间减少了55%(P<.0001)。他们每天低血糖发作(低于70mg/dL)的平均次数从每天1.1次降至0.8次(P<.0001)。患者问卷结果显示受试者满意度较高,且有能力使用和理解该系统。

结论

Freestyle Navigator连续血糖监测系统安全有效,在家庭环境中使用时能使受试者高度满意。使用带有警报的连续血糖监测仪可能通过减少具有临床意义事件的数量和严重程度以及协助维持最佳血糖控制而带来成本抵消。

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