Hirsch Irl B, Verderese Carol A
Endocr Pract. 2017 Nov;23(11):1333-1344. doi: 10.4158/EP171962.RA. Epub 2017 Aug 17.
Recent consensus statements strongly advocate downloading and interpreting continuous glucose data for diabetes management in patients with type 1 or 2 diabetes. Supplementing periodic glycated hemoglobin (A1C) testing with intermittent continuous glucose monitoring (CGM) using a standardized report form known as the ambulatory glucose profile (AGP) is an evolving standard of care. The rationale for this approach and its implementation with a recently approved novel monitoring technology are explored.
Search of the medical literature, professional guidelines, and real-world evidence guided this introduction of an integrative practice framework that uses AGP in conjunction with intermittent flash continuous glucose monitoring (FCGM) as a supplement to A1C testing.
The combination of intermittent continuous glucose pattern analysis, standardized glucose metrics, and a readily interpretable data report has the potential to practically extend the recognized benefits of CGM to more patients and clarify the relationship between A1C and average glucose levels in individual cases.
Novel FCGM technologies portend greater use of continuous forms of glucose monitoring and wider adoption of AGP report analysis. Additional formal and empirical evidence is needed to more fully characterize best practice.
A1C = glycated hemoglobin; AGP = ambulatory glucose profile; CGM = continuous glucose monitoring; FCGM = flash continuous glucose monitoring; IQR = interquartile range; SMBG = self-monitoring of blood glucose.
近期的共识声明强烈主张下载并解读1型或2型糖尿病患者糖尿病管理中的连续血糖数据。使用一种名为动态血糖图谱(AGP)的标准化报告形式,通过间歇性连续血糖监测(CGM)来补充定期糖化血红蛋白(A1C)检测,这是一种不断发展的护理标准。本文探讨了这种方法的基本原理及其在最近获批的新型监测技术中的应用。
通过检索医学文献、专业指南和真实世界证据,引入了一个综合实践框架,该框架将AGP与间歇性闪光连续血糖监测(FCGM)结合使用,作为A1C检测的补充。
间歇性连续血糖模式分析、标准化血糖指标和易于解读的数据报告相结合,有可能将CGM已公认的益处实际扩展到更多患者,并在个别病例中阐明A1C与平均血糖水平之间的关系。
新型FCGM技术预示着连续血糖监测形式的使用将增加,AGP报告分析将得到更广泛的采用。需要更多的正式和实证证据来更全面地描述最佳实践。
A1C = 糖化血红蛋白;AGP = 动态血糖图谱;CGM = 连续血糖监测;FCGM = 闪光连续血糖监测;IQR = 四分位数间距;SMBG = 自我血糖监测