Department of Medicine, Section of Endocrinology and Metabolic Diseases, University di Perugia, Piazzale Gambuli, 1, 06132, Perugia, Italy.
Curr Diab Rep. 2018 Aug 18;18(10):83. doi: 10.1007/s11892-018-1065-6.
In addition to assisting in achieving improved glucose control, continuous glucose monitoring (CGM) sensor technology may also aid in detection and prevention of hypoglycemia. In this paper, we report on the current scientific evidence on the effectiveness of this technology in the prevention of severe hypoglycemia and hypoglycemia unawareness.
Recent studies have found that the integration of CGM with continuous subcutaneous insulin infusion (CSII) therapy, a system known as sensor-augmented pump (SAP) therapy, very significantly reduces the occurrence of these conditions by providing real-time glucose readings/trends and automatically suspending insulin infusion when glucose is low (LGS) or, even, before glucose is low but is predicted to soon be low (PLGS). Initial data indicate that even for patients with type 1 diabetes treated with multiple daily injections, real-time CGM alone has been found to reduce both severe hypoglycemia and hypoglycemia unawareness. Closed loop systems (artificial pancreas) comprised of CGM and CSII without patient intervention to adjust basal insulin, which automatically reduce, increase, and suspend insulin delivery, represent a potential new option that is moving toward becoming a reality in the near future. Sensor technology promises to continue to improve patients' lives not only by attaining glycemic control but also by reducing hypoglycemia, a goal best achieved in conjunction with structured individualized patient education.
除了有助于改善血糖控制外，连续血糖监测（CGM）传感器技术还可能有助于发现和预防低血糖。本文报告了该技术在预防严重低血糖和低血糖无知觉方面的有效性的最新科学证据。
最近的研究发现，CGM 与连续皮下胰岛素输注（CSII）治疗（称为传感器增强型泵（SAP）治疗）相结合，通过提供实时血糖读数/趋势并在血糖低（LGS）时自动暂停胰岛素输注，或甚至在血糖低但预计很快会低（PLGS）时，非常显著地降低了这些情况的发生。初步数据表明，即使对于接受多次每日注射治疗的 1 型糖尿病患者，单独使用实时 CGM 也已被发现可降低严重低血糖和低血糖无知觉的发生。由 CGM 和 CSII 组成的闭环系统（人工胰腺）无需患者干预来调整基础胰岛素，它可自动减少、增加和暂停胰岛素输送，代表了一种潜在的新选择，有望在不久的将来成为现实。传感器技术有望通过实现血糖控制不仅改善患者的生活，而且还通过减少低血糖来改善患者的生活，这一目标最好与结构化的个体化患者教育相结合来实现。
