1 Università Vita-Salute San Raffaele, Milano, Italy.
2 Barbara Davis Center for Diabetes, University of Colorado Anschutz Campus, Aurora, Colorado.
Diabetes Technol Ther. 2019 Jan;21(1):6-10. doi: 10.1089/dia.2018.0257. Epub 2018 Dec 21.
We investigated the efficacy and safety of continuous glucose monitoring (CGM) initiation within 1 year of type 1 diabetes (T1D) diagnosis among children, adolescents, and adults.
Differences in mean A1c (primary outcome) and diabetes-related emergency visits (secondary outcome) for 2.5 years between early CGM users and non-CGM users were studied among 396 newly diagnosed patients with T1D (94% children [age <18 years], 5% adults, 46% females) between January 2013 and December 2015 at Barbara Davis Center for Diabetes. The primary outcome was adjusted by age at diagnosis and gender. P < 0.05 was considered significant.
Gender, ethnicity, body mass index, and A1c at diagnosis were similar between the groups. Irrespective of insulin delivery methods, CGM users had a significantly greater improvement in glycemic control than non-CGM users at 1, 1.5, 2, and 2.5 years. For 2.5 years of follow-up, the multiple daily injection (MDI)+CGM group (n = 19) had 1.5% ± 0.2% lower A1c than the MDI only group (n = 225) (7.7% ± 0.2% vs. 9.2% ± 0.04%, P < 0.0001), and the insulin pump (continuous subcutaneous insulin infusion [CSII])+CGM group (n = 62) had 0.7% ± 0.1% lower A1c than the CSII only group (n = 90) (8.0% ± 0.08% vs. 8.7% ± 0.07%, P < 0.0001). The MDI+CGM group had significantly lower A1c than the CSII only group (7.7% ± 0.2% vs. 8.7% ± 0.07%, P < 0.0001). The number of diabetes-related (severe hypoglycemia or hyperglycemia) emergency department visits was significantly lower among early CGM users compared with non-CGM users (P = 0.003).
Irrespective of insulin delivery system, early initiation of CGM within 1 year from T1D diagnosis was associated with better glucose control and fewer diabetes-related emergency visits.
我们研究了在 1 型糖尿病（T1D）诊断后 1 年内开始连续血糖监测（CGM）对儿童、青少年和成年人的疗效和安全性。
2013 年 1 月至 2015 年 12 月，在芭芭拉戴维斯糖尿病中心（Barbara Davis Center for Diabetes），对 396 名新诊断的 T1D 患者（94%为儿童[年龄<18 岁]，5%为成人，46%为女性）进行了研究，比较了 2.5 年内早期 CGM 用户和非 CGM 用户之间平均 A1c（主要结局）和糖尿病相关急诊就诊（次要结局）的差异。主要结局按诊断时的年龄和性别进行调整。P<0.05 被认为具有统计学意义。
两组患者的性别、种族、体重指数和诊断时的 A1c 相似。无论胰岛素输送方式如何，CGM 用户的血糖控制改善程度均明显优于非 CGM 用户，在 1、1.5、2 和 2.5 年时均如此。在 2.5 年的随访中，多剂量胰岛素注射（MDI）+CGM 组（n=19）的 A1c 比 MDI 组（n=225）低 1.5%±0.2%（7.7%±0.2% vs. 9.2%±0.04%，P<0.0001），胰岛素泵（连续皮下胰岛素输注[CSII]）+CGM 组（n=62）的 A1c 比 CSII 组（n=90）低 0.7%±0.1%（8.0%±0.08% vs. 8.7%±0.07%，P<0.0001）。MDI+CGM 组的 A1c 明显低于 CSII 组（7.7%±0.2% vs. 8.7%±0.07%，P<0.0001）。与非 CGM 用户相比，早期 CGM 用户的糖尿病相关（严重低血糖或高血糖）急诊就诊次数明显减少（P=0.003）。
无论胰岛素输送系统如何，在 T1D 诊断后 1 年内早期开始 CGM 与更好的血糖控制和减少糖尿病相关急诊就诊有关。
