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持续葡萄糖监测:技术与临床应用综述

Continuous glucose monitoring: A review of the technology and clinical use.

作者信息

Klonoff David C, Ahn David, Drincic Andjela

机构信息

Diabetes Research Institute, Mills-Peninsula Health Services, San Mateo, CA, USA.

University of California, Los Angeles, Los Angeles, CA, USA.

出版信息

Diabetes Res Clin Pract. 2017 Nov;133:178-192. doi: 10.1016/j.diabres.2017.08.005. Epub 2017 Sep 1.

Abstract

Continuous glucose monitoring (CGM) is an increasingly adopted technology for insulin-requiring patients that provides insights into glycemic fluctuations. CGM can assist patients in managing their diabetes with lifestyle and medication adjustments. This article provides an overview of the technical and clinical features of CGM based on a review of articles in PubMed on CGM from 1999 through January 31, 2017. A detailed description is presented of three professional (retrospective), three personal (real-time) continuous glucose monitors, and three sensor integrated pumps (consisting of a sensor and pump that communicate with each other to determine an optimal insulin dose and adjust the delivery of insulin) that are currently available in United States. We have reviewed outpatient CGM outcomes, focusing on hemoglobin A1c (A1C), hypoglycemia, and quality of life. Issues affecting accuracy, detection of glycemic variability, strategies for optimal use, as well as cybersecurity and future directions for sensor design and use are discussed. In conclusion, CGM is an important tool for monitoring diabetes that has been shown to improve outcomes in patients with type 1 diabetes mellitus. Given currently available data and technological developments, we believe that with appropriate patient education, CGM can also be considered for other patient populations.

摘要

连续血糖监测(CGM)是一种越来越多地被需要使用胰岛素的患者所采用的技术,它能深入了解血糖波动情况。CGM可帮助患者通过调整生活方式和用药来管理糖尿病。本文基于对1999年至2017年1月31日发表在PubMed上有关CGM的文章的综述,概述了CGM的技术和临床特征。详细介绍了目前在美国可用的三款专业(回顾性)、三款个人(实时)连续血糖监测仪,以及三款传感器集成泵(由相互通信以确定最佳胰岛素剂量并调整胰岛素输送的传感器和泵组成)。我们回顾了门诊CGM的结果,重点关注糖化血红蛋白(A1C)、低血糖和生活质量。讨论了影响准确性、血糖变异性检测、最佳使用策略以及网络安全和传感器设计与使用的未来方向等问题。总之CGM是监测糖尿病的重要工具,已被证明可改善1型糖尿病患者的治疗效果。鉴于目前可得的数据和技术发展,我们认为经过适当的患者教育,CGM也可考虑应用于其他患者群体。

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