Gómez Ana María, Henao Carrillo Diana Cristina, Muñoz Velandia Oscar Mauricio
Endocrinology Unit, Hospital Universitario San Ignacio, Bogotá, Colombia.
Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia.
Med Devices (Auckl). 2017 Sep 12;10:215-224. doi: 10.2147/MDER.S110121. eCollection 2017.
Continuous glucose monitoring (CGM) is a tool that allows constant evaluation of glycemic control, providing data such as the trend and fluctuation of interstitial glucose levels over time. In clinical practice, there are two modalities: the professional or retrospective and the personal or real-time CGM (RT-CGM). The latest-generation sensors are more accurate and sensitive for hypoglycemia, improving adherence to self-monitoring, which has allowed optimizing glycemic control. The development of algorithms that allow the suspension of the infusion of insulin during hypoglycemia gave rise to the integrated therapy or sensor-augmented insulin pump therapy with low glucose suspend, which has proven to be an effective and safe alternative in the treatment of diabetic patients with high risk of hypoglycemia. The objective of this review is to present the evidence of the advantages of RT-CGM, the clinical impact of integrated therapy, and cost-effectiveness of its implementation in the treatment of patients with diabetes mellitus.
连续血糖监测(CGM)是一种能够持续评估血糖控制情况的工具,可提供诸如组织间液葡萄糖水平随时间变化的趋势和波动等数据。在临床实践中,有两种模式:专业版或回顾性模式以及个人版或实时CGM(RT-CGM)。最新一代的传感器对低血糖更为准确和敏感,提高了自我监测的依从性,从而得以优化血糖控制。能够在低血糖期间暂停胰岛素输注的算法的开发催生了集成疗法或具有低血糖暂停功能的传感器增强胰岛素泵疗法,事实证明,这是治疗低血糖高危糖尿病患者的一种有效且安全的替代方法。本综述的目的是展示RT-CGM优势的证据、集成疗法的临床影响及其在糖尿病患者治疗中实施的成本效益。