Rachmiel M, Landau Z, Boaz M, Mazor Aronovitch K, Loewenthal N, Ben-Ami M, Levy-Shraga Y, Modan-Moses D, Haim A, Abiri S, Pinhas-Hamiel O
Pediatric and Adolescent Diabetes Mellitus Service, Assaf Harofeh Medical Center, 70300, Zerifin, Israel,
Acta Diabetol. 2015 Apr;52(2):323-9. doi: 10.1007/s00592-014-0643-6. Epub 2014 Sep 16.
The aim of the study was (a) to compare annual glycemic control in pediatric patients with type 1 diabetes mellitus (T1DM) who used a healthcare-funded continuous glucose monitoring system (RT-CGMS) to that of those who performed self-monitoring blood glucose (SMBG) only, in a real-life setting, and (b) to define parameters associated with compliance and glycemic control.
A total of 149 youth with T1DM (52.3 % females), mean age 11.8 ± 3.6 years, and 83 in the CGMS group were followed prospectively for 12 months. Glycemic control parameters and compliance to RT-CGMS were assessed periodically.
Glycemic parameters did not differ significantly between the groups during follow-up periods. The time spent with RT-CGMS decreased and only 38 % used it for more than 75 % of the time during the 12 months (consistent users). Mean HbA1c decreased by 0.27 % in consistent users and increased by 0.21 % among intermittent users (used RT-CGMS less than 75 % of time), p = 0.013. Consistent users were younger 10. 6 ± 4.2 vs. 12.5 ± 3.6, p = 0.07, and had higher frequency of SMBG at baseline, 10.6 ± 4.9 vs. 6.3 ± 2.8, p = 0.011.
The adoption of RT-CGMS was low, even in a healthcare system that funds its use. Caregivers should consider patient characteristics when recommending RT-CGMS use.
本研究的目的是（a）在现实生活环境中，比较使用医疗保健资助的持续葡萄糖监测系统（实时动态血糖监测系统，RT-CGMS）的1型糖尿病（T1DM）儿科患者与仅进行自我血糖监测（SMBG）的患者的年度血糖控制情况，以及（b）确定与依从性和血糖控制相关的参数。
共有149名T1DM青少年（52.3%为女性），平均年龄11.8±3.6岁，其中83名在CGMS组，前瞻性随访12个月。定期评估血糖控制参数和对RT-CGMS的依从性。
随访期间两组的血糖参数无显著差异。使用RT-CGMS的时间减少，在12个月期间只有38%的人使用时间超过75%（持续使用者）。持续使用者的平均糖化血红蛋白（HbA1c）下降了0.27%，间歇性使用者（使用RT-CGMS时间少于75%）上升了0.21%，p = 0.013。持续使用者更年轻，10.6±4.2岁对12.5±3.6岁，p = 0.07，且基线时自我血糖监测频率更高，10.6±4.9次对6.3±2.8次，p = 0.011。
即使在资助其使用的医疗保健系统中，RT-CGMS的采用率也很低。护理人员在推荐使用RT-CGMS时应考虑患者特征。
