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实时连续血糖监测系统在血糖控制不佳的青少年 1 型糖尿病患者中的教育和激励作用:每月使用一次

Monthly use of a real-time continuous glucose monitoring system as an educational and motivational tool for poorly controlled type 1 diabetes adolescents.

出版信息

Adv Med Sci. 2013;58(2):344-52. doi: 10.2478/ams-2013-0024.

Abstract

PURPOSE

Experience with the use of real-time continuous glucose monitoring systems (RT-CGMS) in teenagers with type 1 diabetes mellitus (T1DM) is limited. We aimed to assess the possibility of glycaemic control improvement and to characterize the group of adolescents, who may gain long-term benefits from the use of the RT-CGMS.

METHODS

Forty T1DM patients, aged 14.6 ± 2.1 years, with diabetes duration 7.4 ± 3.6 years and initial HbA₁c 9.3 ± 1.5% were recruited. The analysis was based on one-month glucose sensors use, combined with the thorough family support. Patients were analysed in groups according to baseline HbA₁c: below and above 7.5%, and 10.0%. Comparison between patients with or without improvement in HbA₁c after 3-month follow-up was also performed. Patients' satisfaction based on the questionnaire was assessed.

RESULTS

HbA₁c level in entire study group decreased after three months, from 9.3 ± 1.0% to 8.8 ± 1.6% (P<0.001). In the group with HbA1c improvement, reduction was the highest: 9.0 ± 1.3% vs. 8.0 ± 1.2% (P<0.001). Only the group with initial HbA₁c>10% did not achieve significant improvement: 11.2 ± 0.5% vs. 10.9 ± 1.1 (P=0.06). In satisfaction questionnaire the lowest scores (negative opinion) were reported by group of patients with initial HbA₁c above 10%, while the highest scores (positive opinion) were found in the group with improvement of HbA₁c after 3 month follow-up.

CONCLUSION

Short-term use of CGMS RT, united with satisfaction questionnaire, performed in poorly controlled teenagers with T1DM, can be useful in defining the group of young patients, who can benefit from long-term CGMS RT use in metabolic control improvement.

摘要

目的

实时连续血糖监测系统(RT-CGMS)在 1 型糖尿病(T1DM)青少年中的应用经验有限。我们旨在评估改善血糖控制的可能性,并对可能从 RT-CGMS 使用中长期获益的青少年群体进行特征描述。

方法

招募了 40 名年龄为 14.6±2.1 岁、糖尿病病程为 7.4±3.6 年且初始 HbA₁c 为 9.3±1.5%的 T1DM 患者。该分析基于一个月的葡萄糖传感器使用,并结合了全面的家庭支持。根据基线 HbA₁c 将患者分为以下两组:低于和高于 7.5%,以及 10.0%。还对 3 个月随访后 HbA₁c 改善或未改善的患者进行了比较。通过问卷调查评估了患者的满意度。

结果

整个研究组的 HbA₁c 水平在三个月后从 9.3±1.0%下降到 8.8±1.6%(P<0.001)。在 HbA1c 改善的组中,下降幅度最大:9.0±1.3%比 8.0±1.2%(P<0.001)。仅初始 HbA₁c>10%的组未取得显著改善:11.2±0.5%比 10.9±1.1%(P=0.06)。在满意度问卷中,初始 HbA₁c 高于 10%的患者组报告的评分最低(负面意见),而 HbA₁c 在 3 个月随访后改善的患者组报告的评分最高(正面意见)。

结论

在血糖控制不佳的 T1DM 青少年中短期使用 CGMS RT,并结合满意度问卷,可以帮助确定那些可以从长期 CGMS RT 使用中获益以改善代谢控制的年轻患者群体。

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