Department of Endocrinology and Metabolism, Diabetes Institute, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Diabetes Care. 2012 Jan;35(1):32-8. doi: 10.2337/dc11-1438. Epub 2011 Nov 18.
To determine whether short-time, real-time continuous glucose monitoring (RT-CGM) has long-term salutary glycemic effects in patients with type 2 diabetes who are not on prandial insulin.
This was a randomized controlled trial of 100 adults with type 2 diabetes who were not on prandial insulin. This study compared the effects of 12 weeks of intermittent RT-CGM with self-monitoring of blood glucose (SMBG) on glycemic control over a 40-week follow-up period. Subjects received diabetes care from their regular provider without therapeutic intervention from the study team.
There was a significant difference in A1C at the end of the 3-month active intervention that was sustained during the follow-up period. The mean, unadjusted A1C decreased by 1.0, 1.2, 0.8, and 0.8% in the RT-CGM group vs. 0.5, 0.5, 0.5, and 0.2% in the SMBG group at 12, 24, 38, and 52 weeks, respectively (P = 0.04). There was a significantly greater decline in A1C over the course of the study for the RT-CGM group than for the SMBG group, after adjusting for covariates (P < 0.0001). The subjects who used RT-CGM per protocol (≥48 days) improved the most (P < 0.0001). The improvement in the RT-CGM group occurred without a greater intensification of medication compared with those in the SMBG group.
Subjects with type 2 diabetes not on prandial insulin who used RT-CGM intermittently for 12 weeks significantly improved glycemic control at 12 weeks and sustained the improvement without RT-CGM during the 40-week follow-up period, compared with those who used only SMBG.
确定在未使用餐前胰岛素的 2 型糖尿病患者中，短期实时连续血糖监测（RT-CGM）是否具有长期有益的血糖作用。
这是一项针对 100 名未使用餐前胰岛素的 2 型糖尿病成人患者的随机对照试验。本研究比较了 12 周间歇性 RT-CGM 与自我监测血糖（SMBG）对 40 周随访期间血糖控制的影响。受试者接受其常规提供者的糖尿病护理，而不受研究团队的治疗干预。
在为期 3 个月的积极干预结束时，A1C 存在显著差异，并且在随访期间得以维持。在 RT-CGM 组中，未经调整的 A1C 在 12、24、38 和 52 周时分别下降了 1.0、1.2、0.8 和 0.8%，而在 SMBG 组中则分别下降了 0.5、0.5、0.5 和 0.2%（P = 0.04）。在调整协变量后，RT-CGM 组的 A1C 在研究过程中下降幅度明显大于 SMBG 组（P < 0.0001）。按照方案使用 RT-CGM（≥48 天）的患者改善最明显（P < 0.0001）。与 SMBG 组相比，RT-CGM 组的药物强化程度没有增加，血糖就得到了改善。
未使用餐前胰岛素的 2 型糖尿病患者间歇性使用 RT-CGM 12 周可显著改善 12 周时的血糖控制，并在 40 周随访期间无需使用 RT-CGM 即可维持改善，而仅使用 SMBG 的患者则没有这种改善。
