Wadwa R Paul, Fiallo-Scharer Rosanna, Vanderwel Brandon, Messer Laurel H, Cobry Erin, Chase H Peter
Barbara Davis Center for Childhood Diabetes, Aurora, Colorado 80045, USA.
Diabetes Technol Ther. 2009 Jun;11 Suppl 1:S83-91. doi: 10.1089/dia.2008.0122.
Continuous glucose monitoring (CGM) is becoming increasingly popular and represents the third era of diabetes management. Currently available CGM devices have been studied in youth with type 1 diabetes and show similar accuracy across all age groups. Tolerability of these devices relates to alarm settings, sensor skin irritation, and durability of the device. Youth will be most successful on a CGM regimen if they have a personal investment in wearing the CGM device and have a stable support system for their diabetes care. Data indicate that glycemic control improves the most in youth who wear CGM devices >or=5 days per week, allowing for the ability to make more insulin dose changes. CGM has proven useful in alerting youth to hypoglycemia and may be a valuable tool with exercise. Further studies are needed to assess the utility of CGM for prevention of severe hypoglycemic events and increasing time spent in euglycemia. Fear of hypoglycemia may be ameliorated with CGM use; however, the potential for increased stress in families with continuous feedback must also be considered. In the future, CGM use in youth may couple with insulin pump technology to create a "closed-loop" system in which the CGM device will direct insulin administration without user input.
持续葡萄糖监测（CGM）正变得越来越流行，代表了糖尿病管理的第三个时代。目前可用的CGM设备已在1型糖尿病青少年中进行了研究，并且在所有年龄组中都显示出相似的准确性。这些设备的耐受性与警报设置、传感器对皮肤的刺激以及设备的耐用性有关。如果青少年对佩戴CGM设备有个人投入并且有稳定的糖尿病护理支持系统，那么他们在CGM治疗方案上会最为成功。数据表明，每周佩戴CGM设备≥5天的青少年血糖控制改善最为明显，这使得他们有能力进行更多的胰岛素剂量调整。CGM已被证明在提醒青少年低血糖方面有用，并且在运动时可能是一个有价值的工具。需要进一步研究来评估CGM在预防严重低血糖事件和增加血糖正常时间方面的效用。使用CGM可能会减轻对低血糖的恐惧；然而，也必须考虑持续反馈给家庭带来的压力增加的可能性。未来，青少年使用CGM可能会与胰岛素泵技术相结合，创建一个“闭环”系统，在该系统中，CGM设备将无需用户输入即可指导胰岛素给药。
