Diabetes Care. 2009 Nov;32(11):1947-53. doi: 10.2337/dc09-0889. Epub 2009 Aug 12.
To evaluate factors associated with successful use of continuous glucose monitoring (CGM) among participants with intensively treated type 1 diabetes in the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Randomized Clinical Trial.
The 232 participants randomly assigned to the CGM group (165 with baseline A1C >or=7.0% and 67 with A1C <7.0%) were asked to use CGM on a daily basis. The associations of baseline factors and early CGM use with CGM use >or=6 days/week in the 6th month and with change in A1C from baseline to 6 months were evaluated in regression models.
The only baseline factors found to be associated with greater CGM use in month 6 were age >or=25 years (P < 0.001) and more frequent self-reported prestudy blood glucose meter measurements per day (P < 0.001). CGM use and the percentage of CGM glucose values between 71 and 180 mg/dl during the 1st month were predictive of CGM use in month 6 (P < 0.001 and P = 0.002, respectively). More frequent CGM use was associated with a greater reduction in A1C from baseline to 6 months (P < 0.001), a finding present in all age-groups.
After 6 months, near-daily CGM use is more frequent in intensively treated adults with type 1 diabetes than in children and adolescents, although in all age-groups near-daily CGM use is associated with a similar reduction in A1C. Frequency of blood glucose meter monitoring and initial CGM use may help predict the likelihood of long-term CGM benefit in intensively treated patients with type 1 diabetes of all ages.
评估强化治疗 1 型糖尿病患者使用连续血糖监测(CGM)的成功因素,该研究来自青少年糖尿病研究基金会连续血糖监测随机临床试验。
232 名参与者被随机分配到 CGM 组(基线 A1C≥7.0%的 165 名,A1C<7.0%的 67 名),要求他们每天使用 CGM。在回归模型中,评估了基线因素和早期 CGM 使用与第 6 个月 CGM 使用>6 天/周以及与基线至 6 个月 A1C 变化的相关性。
唯一与第 6 个月 CGM 使用量增加相关的基线因素是年龄≥25 岁(P<0.001)和自我报告的研究前每天血糖仪测量次数更多(P<0.001)。第 1 个月 CGM 使用量和 CGM 葡萄糖值在 71-180mg/dl 之间的百分比是第 6 个月 CGM 使用量的预测因素(P<0.001 和 P=0.002)。更频繁地使用 CGM 与从基线到 6 个月 A1C 的降低相关(P<0.001),这一发现存在于所有年龄组中。
在 6 个月后,强化治疗的 1 型糖尿病成人比儿童和青少年更频繁地接近每日使用 CGM,但在所有年龄组中,接近每日使用 CGM 与 A1C 的相似降低相关。血糖仪监测的频率和初始 CGM 使用可能有助于预测所有年龄段强化治疗的 1 型糖尿病患者长期 CGM 获益的可能性。