Levitt David L, Silver Kristi D, Spanakis Elias K
1 Division of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA.
2 Division of Endocrinology, Diabetes, and Nutrition, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA.
J Diabetes Sci Technol. 2017 Sep;11(5):1028-1035. doi: 10.1177/1932296817698499. Epub 2017 Mar 14.
Continuous glucose monitoring (CGM) is commonly used in the outpatient setting to improve diabetes management. CGM can provide real-time glucose trends, detecting hyperglycemia and hypoglycemia before the onset of clinical symptoms. In 2011, at the time the Endocrine Society CGM guidelines were published, the society did not recommend inpatient CGM as its efficacy and safety were unknown. While many studies have subsequently evaluated inpatient CGM accuracy and reliability, glycemic outcome studies have not been widely published. In the non-ICU setting, investigational CGM studies have commonly blinded providers and patients to glucose data. Retrospective review of the glucose data reflects increased hypoglycemia detection with CGM. In the ICU setting, data are inconsistent whether CGM can improve glycemic outcomes. Studies have not focused on hospitalized patients with type 1 diabetes mellitus, the population most likely to benefit from inpatient CGM. This article reviews inpatient CGM glycemic outcomes in the non-ICU and ICU setting.
连续血糖监测(CGM)常用于门诊环境以改善糖尿病管理。CGM可提供实时血糖趋势,在临床症状出现前检测出高血糖和低血糖。2011年,在内分泌学会发布CGM指南时,该学会不推荐在住院患者中使用CGM,因为其疗效和安全性尚不清楚。尽管随后有许多研究评估了住院患者CGM的准确性和可靠性,但关于血糖结果的研究尚未广泛发表。在非重症监护病房(ICU)环境中,CGM的研究通常会对医护人员和患者隐瞒血糖数据。对血糖数据的回顾性分析表明,CGM可增加低血糖的检测。在ICU环境中,关于CGM能否改善血糖结果的数据并不一致。研究尚未聚焦于1型糖尿病住院患者,而这一人群最有可能从住院患者CGM中获益。本文综述了非ICU和ICU环境下住院患者CGM的血糖结果。