Division of Diabetes, Nutrition and Metabolic Disorders, CHU de Liège, University of Liège, CHU Sart Tilman, bâtiment B35, 4000 Liège, Belgium.
Diabetes Metab. 2010 Nov;36(5):409-13. doi: 10.1016/j.diabet.2010.08.001. Epub 2010 Sep 22.
This study aimed to assess the effectiveness of continuous glucose monitoring (CGM) for glucose control in type 1 diabetic patients treated by continuous subcutaneous insulin infusion (CSII) and presenting with frequent hypoglycaemic episodes.
Thirteen patients with type 1 diabetes (diabetes duration: 25±15 years; CSII duration: 5.5±7.0 years), with more than six recorded capillary blood glucose (CBG) values <60 mg/dL, according to their metres for the past 14 days, were offered the permanent use of a CGM device (Guardian RT(®), Medtronic) plus ongoing self-monitoring of blood glucose (SMBG) for 12 weeks, followed by a 12-week crossover period of SMBG only, or vice versa. Glucose control, determined by recorded 14-day CBG values <60 mg/dL and HbA(1c) levels, and quality of life according to the Diabetes Quality of Life (DQOL) questionnaire, were assessed at baseline, and after 12- and 24-week follow-ups.
Four patients withdrew from the study during the first period (of whom three were using CGM). In the nine study completers, the number of low CBG values decreased significantly from 13.9±9.2 to 7.6±6.8 (P=0.011) when patients used CGM, in either the initial or final trial period, while a decrease in HbA(1c) from 8.3±0.7 to 7.7±0.6% (P=0.049) was also observed, in contrast to the absence of any significant differences during the SMBG-only period. DQOL scores were also essentially unaffected.
This pilot observational study supports the hypothesis that CGM use can significantly improve overall glucose control while reducing hypoglycaemic episodes in hypoglycaemia-prone type 1 diabetic patients treated by CSII.
本研究旨在评估连续血糖监测（CGM）在频繁发生低血糖的 1 型糖尿病患者接受连续皮下胰岛素输注（CSII）治疗时对血糖控制的有效性。
13 例 1 型糖尿病患者（糖尿病病程：25±15 年；CSII 病程：5.5±7.0 年），根据过去 14 天的血糖仪记录，有超过 6 次血糖值＜60mg/dL，接受了永久性 CGM 设备（Guardian RT（®），美敦力）和持续自我血糖监测（SMBG）治疗 12 周，随后是 12 周的 SMBG 交叉期，或反之。通过记录的 14 天血糖值＜60mg/dL 和糖化血红蛋白（HbA1c）水平评估血糖控制情况，并根据糖尿病生活质量（DQOL）问卷评估生活质量，在基线、12 周和 24 周随访时进行评估。
4 例患者在第一个试验期（其中 3 例使用 CGM）退出研究。在 9 例完成研究的患者中，当患者使用 CGM 时，初始或最终试验期的低血糖值（CBG）从 13.9±9.2 次显著减少到 7.6±6.8 次（P=0.011），而 HbA1c 从 8.3±0.7%降低到 7.7±0.6%（P=0.049），而在仅 SMBG 期间没有观察到任何显著差异。DQOL 评分也基本没有变化。
这项初步观察性研究支持了 CGM 使用可显著改善血糖控制，同时减少接受 CSII 治疗的易发生低血糖的 1 型糖尿病患者低血糖发作的假说。
