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2型糖尿病非胰岛素治疗患者的连续血糖监测:可接受性、可行性及教学机会

Continuous glucose monitoring in non-insulin-using individuals with type 2 diabetes: acceptability, feasibility, and teaching opportunities.

作者信息

Allen Nancy A, Fain James A, Braun Barry, Chipkin Stuart R

机构信息

Yale University, New Haven, Connecticut, USA.

出版信息

Diabetes Technol Ther. 2009 Mar;11(3):151-8. doi: 10.1089/dia.2008.0053.

Abstract

BACKGROUND

Continuous glucose monitoring (CGM) has the potential to provide useful data for behavioral interventions targeting non-insulin-using, sedentary individuals with type 2 diabetes mellitus (T2DM). The aims of this study were to describe CGM in terms of (1) feasibility and acceptability and (2) dietary- and exercise-teaching events.

METHODS

Cross-sectional data were analyzed from 27 non-insulin-using adults with T2DM who wore CGM for 72 h as part of a larger study on using CGM for exercise counseling in this population. Feasibility data included accuracy of entering daily self-monitored blood glucose (SMBG) readings and events (e.g., meals, exercise), sensor failures, alarms, optimal accuracy of glucose data, and download failures. Acceptability data included CGM satisfaction and wearing difficulties. Dietary- and exercise-teaching events were identified from CGM and activity monitor data.

RESULTS

CGM graphs showed 141 dietary- and 71 exercise-teaching events. About half the participants (52%) reported difficulty remembering to enter events into CGM monitors, but most (82%) kept an accurate paper log of events. Insufficient SMBG entries resulted in 32 CGM graphs with "use clinical judgment" warnings. Eighty-three percent of missed SMBG entries were from 18 participants 55-77 years old. Missing correlation coefficients resulted from glucose concentrations varying <100 mg/dL. A majority of participants (n = 19) were willing to wear CGM again despite reporting minor discomfort at sensor site and with wearing the monitor.

CONCLUSIONS

CGM data provided several teaching opportunities in non-insulin-using adults with T2DM. Overall, CGM was acceptable and feasible. Some identified problems may be eliminated by newer technology.

摘要

背景

连续血糖监测(CGM)有可能为针对不使用胰岛素的久坐2型糖尿病(T2DM)患者的行为干预提供有用数据。本研究的目的是从以下两个方面描述CGM:(1)可行性和可接受性;(2)饮食和运动教学事件。

方法

对27名不使用胰岛素的T2DM成年患者的横断面数据进行分析,这些患者佩戴CGM 72小时,作为该人群使用CGM进行运动咨询的一项更大规模研究的一部分。可行性数据包括输入每日自我监测血糖(SMBG)读数和事件(如饮食、运动)的准确性、传感器故障、警报、血糖数据的最佳准确性以及下载失败情况。可接受性数据包括CGM满意度和佩戴困难情况。从CGM和活动监测数据中识别饮食和运动教学事件。

结果

CGM图表显示了141次饮食和71次运动教学事件。约一半的参与者(52%)报告难以记住将事件输入CGM监测仪,但大多数(82%)保留了准确的事件纸质记录。SMBG输入不足导致32张CGM图表出现“使用临床判断”警告。83%未输入的SMBG读数来自18名55至77岁的参与者。由于血糖浓度变化<100 mg/dL,导致相关系数缺失。尽管大多数参与者(n = 19)报告传感器部位和佩戴监测仪时有轻微不适,但仍愿意再次佩戴CGM。

结论

CGM数据为不使用胰岛素的T2DM成年患者提供了多个教学机会。总体而言,CGM是可接受且可行的。一些已发现的问题可能会被更新的技术消除。

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