Mohan Viswanathan, Jain Sunil, Kesavadev Jothydev, Chawla Manoj, Mutha Abhay, Viswanathan Vijay, Saboo Banshi, Kovil Rajiv, Mithal Ambrish, Punatar Dharmen, Shin John
Chairman and Chief Diabetologist, Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu.
Head of the Dept., Endocrinology TOTALL Diabetes Hormone Institute, Indore, Madhya Pradesh.
J Assoc Physicians India. 2016 Apr;64(4):16-21.
Retrospective continuous glucose monitoring (CGM) studies may provide healthcare professionals (HCPs) with better understanding of glycemic patterns in patients with type 2 diabetes (T2D) and thereby support patient education and appropriate therapeutic interventions.
Adults with T2D and A1C values between 8% and 10% were eligible for this 3-month study. Patients were scheduled for 5 visits that included baseline and a month-2 retrospective CGM study (iPro2, Medtronic) followed by data review and therapy modifications. A1C values were determined at baseline and at study end. Questionnaires were completed at each visit. HCP questionnaires assessed perception of the utility of studies; patient questionnaires assessed understanding of the importance of compliance with HCP recommendations. Indices of glycemic variability and control were calculated from CGM data retrospectively.
A total of 181 subjects enrolled and 148 completed the study (81.8%). There were no serious adverse device effects. Most subjects (91.2%) had > 1 therapy change after review of the first iPro2 test. Mean A1C decreased from 8.6% at baseline to 8.0% at month 3 (p<0.001). Questionnaire results from patients and HCPs indicated that both groups viewed the iPro2 studies and results as acceptable and useful. CGM-based glycemic variability metrics were similar in the two iPro2 tests.
iPro2 studies provided HCPs with insights and opportunities for initiating changes to treatment regimens and to diet and exercise behaviors, and provided patients with improved knowledge of the importance of therapy compliance. Favorable reductions in A1C suggest that iPro2 tests can facilitate optimal management of T2D.
回顾性连续血糖监测（CGM）研究可为医疗保健专业人员（HCPs）提供对2型糖尿病（T2D）患者血糖模式的更好理解，从而支持患者教育和适当的治疗干预。
A1C值在8%至10%之间的成年T2D患者符合这项为期3个月的研究条件。患者安排进行5次就诊，包括基线检查和第2个月的回顾性CGM研究（美敦力iPro2），随后进行数据审查和治疗调整。在基线和研究结束时测定A1C值。每次就诊时完成问卷调查。HCP问卷评估对研究效用的看法；患者问卷评估对遵守HCP建议重要性的理解。从CGM数据中回顾性计算血糖变异性和控制指标。
共有181名受试者入组，148名完成研究（81.8%）。没有严重的器械不良影响。大多数受试者（91.2%）在第一次iPro2测试审查后有>1次治疗改变。平均A1C从基线时的8.6%降至第3个月时的8.0%（p<0.001）。患者和HCP的问卷结果表明，两组都认为iPro2研究及结果是可接受且有用的。两次iPro2测试中基于CGM的血糖变异性指标相似。
iPro2研究为HCP提供了见解和机会，以启动治疗方案以及饮食和运动行为的改变，并为患者提供了对治疗依从性重要性的更好认识。A1C的有利降低表明iPro2测试可促进T2D的最佳管理。
