Peyrot Mark, Rubin Richard R
Department of Sociology, Loyola College in Maryland, Baltimore, 21210-2699, USA.
Diabetes Technol Ther. 2009 Jan;11(1):57-62. doi: 10.1089/dia.2008.0002.
A 16-week, two-site study evaluated outcomes for a new device (the Paradigm 722 System, Medtronic MiniMed, Northridge, CA) that combines a "smart" continuous subcutaneous insulin infusion (CSII) pump with real-time (RT) continuous glucose monitoring (CGM) and CareLinktrade mark data management software (DMS).
CSII-naive adults with type 1 diabetes in suboptimal control (mean glycosylated hemoglobin [A1C] = 8.6%) were randomized to the control arm, consisting of multiple daily injections (MDI) and self-monitoring of blood glucose (SMBG), or the study arm (CSII with RT-CGM as an adjunct to SMBG). Participants (n = 28) completed the validated Insulin Delivery System Rating Questionnaire (IDSRQ) and the parallel Blood Glucose (BG) Monitoring System Rating Questionnaire (BGMSRQ) at study start and end. Participants in the study arm (n = 14) also completed newly developed User Acceptance Questionnaires (UAQs) for CSII, RT-CGM, and DMS at study end.
A1C reduction from study start to end was significant (P < 0.05) in both arms (-1.7% for study arm;-1.0% for control arm); there was no significant change in weight in either arm. The IDSRQ showed significantly (P < 0.05) greater benefit for the study arm in convenience, acceptability of BG monitoring requirements, BG control efficacy, diabetes worries, and interpersonal hassles, as well as higher overall satisfaction/preference. The BGMSRQ showed significantly (P < 0.05) greater benefit for the study arm in the BG monitoring system's ability to help manage glycemic control and less interest in changing to another BG monitoring system. The Study Arm UAQs showed positive ratings of system features.
Several patient-reported outcomes were significantly more positive in the study arm than the control arm; none was significantly more positive in the control arm. The features of the integrated RT-CGM/CSII system were frequently used and highly rated by participants, with high user satisfaction.
一项为期16周、在两个地点开展的研究评估了一种新设备(美敦力迷你迈德公司的Paradigm 722系统,位于加利福尼亚州北岭)的效果,该设备将“智能”持续皮下胰岛素输注(CSII)泵与实时(RT)持续葡萄糖监测(CGM)以及CareLink商标数据管理软件(DMS)相结合。
糖化血红蛋白(A1C)均值为8.6%、控制不佳的1型糖尿病初用CSII的成人患者被随机分为对照组(采用每日多次注射(MDI)及自我血糖监测(SMBG))或研究组(CSII联合RT-CGM作为SMBG的辅助手段)。参与者(n = 28)在研究开始和结束时完成了经过验证的胰岛素输注系统评分问卷(IDSRQ)和平行的血糖(BG)监测系统评分问卷(BGMSRQ)。研究组的参与者(n = 14)在研究结束时还完成了针对CSII、RT-CGM和DMS新开发的用户接受度问卷(UAQ)。
两组从研究开始到结束时A1C均显著降低(P < 0.05)(研究组为-1.7%;对照组为-1.0%);两组体重均无显著变化。IDSRQ显示,研究组在便利性、血糖监测要求的可接受性、血糖控制效果、糖尿病担忧及人际困扰方面有显著(P < 0.05)更大的益处,总体满意度/偏好也更高。BGMSRQ显示,研究组在血糖监测系统帮助管理血糖控制的能力方面有显著(P < 0.05)更大的益处,且对更换为另一种血糖监测系统的兴趣较低。研究组的UAQ对系统功能给出了积极评价。
研究组在一些患者报告的结果方面显著优于对照组;对照组在任何方面均未显著更优。集成式RT-CGM/CSII系统的功能被参与者频繁使用且评价很高,用户满意度高。