持续葡萄糖监测的依从性：一项预测门诊行为的临床试验经验教训。
Continuous Glucose Monitoring Adherence: Lessons From a Clinical Trial to Predict Outpatient Behavior.
作者信息
de Bock Martin, Cooper Matthew, Retterath Adam, Nicholas Jennifer, Ly Trang, Jones Timothy, Davis Elizabeth
机构信息
Telethon Kids Institute, University of Western Australia, Perth, Australia Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Perth, Western Australia, Australia School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
Telethon Kids Institute, University of Western Australia, Perth, Australia.
出版信息
J Diabetes Sci Technol. 2016 May 3;10(3):627-32. doi: 10.1177/1932296816633484. Print 2016 May.
AIMS
This study reports continuous glucose monitoring (CGM) adherence patterns and contributing factors in patients who were part of a 6-month clinical trial using sensor augmented pump therapy with low glucose insulin suspension.
METHODS
CGM data from 38 patients using sensor augmented pump therapy for 6 months were analyzed. CGM adherence was defined by having a working sensor available and determined by the time it was switched on as a proportion of available time for the 6 month study period with allowance for practical CGM use. Age, gender, HbA1c, duration of diagnosis, capillary blood glucose testing frequency, sensor accuracy, and insulin pump alarm frequency were characterized and examined for an association with CGM adherence.
RESULTS
Overall CGM adherence was 75% (range: 35% to 96%), CGM adherence was demonstrated to fall after 9 to 11 weeks before reaching a steady rate. CGM adherence patterns showed substantial variation. Mean adherence differed (P < .01) between age groups 72% (<12 years), 69% (12-18 years), and 88% (≥18 years). Sensor accuracy predicted adherence, where every 1% decline in mean absolute difference in a given week was associated with a 0.5% decline in sensor adherence (P < .01). Gender, HbA1c, duration of diagnosis, capillary blood glucose testing frequency, and insulin pump alarm frequency were not associated with CGM adherence.
CONCLUSIONS
CGM adherence and patterns of use are individualized. However, a predictable fall in adherence at 9 to 11 weeks may present an opportunity for timed interventions to increase CGM use. Adolescent age and sensor accuracy predict CGM adherence.
目的
本研究报告了在一项为期6个月的临床试验中，使用带有低血糖胰岛素悬浮液的传感器增强泵疗法的患者的连续血糖监测（CGM）依从模式及影响因素。
方法
分析了38例使用传感器增强泵疗法6个月的患者的CGM数据。CGM依从性定义为有一个可用的工作传感器，并根据其在6个月研究期间开启时间占可用时间的比例来确定，同时考虑到CGM的实际使用情况。对年龄、性别、糖化血红蛋白（HbA1c）、诊断时长、毛细血管血糖检测频率、传感器准确性和胰岛素泵警报频率进行了特征描述，并检查它们与CGM依从性之间的关联。
结果
总体CGM依从性为75%（范围：35%至96%），CGM依从性在9至11周后下降，之后达到稳定速率。CGM依从模式显示出很大差异。不同年龄组之间的平均依从性存在差异（P <.01），<12岁组为72%，12 - 18岁组为69%，≥18岁组为88%。传感器准确性可预测依从性，在给定周内平均绝对差每下降1%，传感器依从性就会下降0.5%（P <.01）。性别、HbA1c、诊断时长、毛细血管血糖检测频率和胰岛素泵警报频率与CGM依从性无关。
结论
CGM依从性和使用模式是因人而异的。然而，在9至11周时依从性的可预测下降可能为进行定时干预以增加CGM使用提供了机会。青少年年龄和传感器准确性可预测CGM依从性。
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