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动态血糖监测在临床试验中的作用:报告建议

Role of Continuous Glucose Monitoring in Clinical Trials: Recommendations on Reporting.

作者信息

Schnell Oliver, Barnard Katharine, Bergenstal Richard, Bosi Emanuele, Garg Satish, Guerci Bruno, Haak Thomas, Hirsch Irl B, Ji Linong, Joshi Shashank R, Kamp Maarten, Laffel Lori, Mathieu Chantal, Polonsky William H, Snoek Frank, Home Philip

机构信息

1 Forschergruppe Diabetes e.V., Helmholtz Zentrum, Munich , Germany .

2 Bournemouth University , Faculty of Health and Social Science, Bournemouth, United Kingdom .

出版信息

Diabetes Technol Ther. 2017 Jul;19(7):391-399. doi: 10.1089/dia.2017.0054. Epub 2017 May 22.

Abstract

Thanks to significant improvements in the precision, accuracy, and usability of continuous glucose monitoring (CGM), its relevance in both ambulatory diabetes care and clinical research is increasing. In this study, we address the latter perspective and derive provisional reporting recommendations. CGM systems have been available since around the year 2000 and used primarily in people with type 1 diabetes. In contrast to self-measured glucose, CGM can provide continuous real-time measurement of glucose levels, alerts for hypoglycemia and hyperglycemia, and a detailed assessment of glycemic variability. Through a broad spectrum of derived glucose data, CGM should be a useful tool for clinical evaluation of new glucose-lowering medications and strategies. It is the only technology that can measure hyperglycemic and hypoglycemic exposure in ambulatory care, or provide data for comprehensive assessment of glucose variability. Other advantages of current CGM systems include the opportunity for improved self-management of glycemic control, with particular relevance to those at higher risk of or from hypoglycemia. We therefore summarize the current status and limitations of CGM from the perspective of clinical trials and derive suggested recommendations for how these should facilitate optimal CGM use and reporting of data in clinical research.

摘要

由于连续血糖监测(CGM)在精度、准确性和易用性方面取得了显著进步,其在门诊糖尿病护理和临床研究中的相关性日益增加。在本研究中,我们探讨了后者的观点并得出了临时报告建议。CGM系统自2000年左右开始可用,主要用于1型糖尿病患者。与自我测量血糖不同,CGM可以提供血糖水平的连续实时测量、低血糖和高血糖警报,以及对血糖变异性的详细评估。通过广泛的衍生血糖数据,CGM应该是临床评估新型降糖药物和策略的有用工具。它是唯一能够在门诊护理中测量高血糖和低血糖暴露,或提供用于全面评估血糖变异性数据的技术。当前CGM系统的其他优点包括改善血糖控制自我管理的机会,这对低血糖风险较高或易发生低血糖的患者尤为重要。因此,我们从临床试验的角度总结了CGM的现状和局限性,并得出了关于如何在临床研究中促进最佳CGM使用和数据报告的建议。

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