Dexcom, Inc., San Diego, California.
Diabetes Technol Ther. 2019 Apr;21(4):155-158. doi: 10.1089/dia.2018.0359. Epub 2019 Mar 22.
Programmable and fixed auditory and/or vibratory threshold alerts are essential features of real-time continuous glucose monitoring (rtCGM) systems that provide users time to intervene before the onset of clinical hypoglycemia or hyperglycemia. A sixth-generation rtCGM system from Dexcom, Inc. (G6) includes a new alert that is triggered when an algorithm predicts that an estimated glucose value ≤55 mg/dL will occur within 20 min, allowing users more time to act to avoid hypoglycemia. We examined whether this predictive low glucose alert provided added benefit to traditional low threshold alerts.
We analyzed glucose values from an anonymized sample of 1424 patients who transitioned to G6 from the preceding fifth-generation system (G5) with no predictive alert. Users with the low threshold alert setting of 70 or 80 mg/dL were evaluated separately. Receiver users, those who disabled the predictive low glucose alert, or those with <30 days of data immediately before or after the transition to G6 were excluded.
Percent time <54, ≤55, <70, and >250 mg/dL fell significantly after the transition to G6, independent of low threshold alert setting. Time in range improved for G6 users with a low threshold alert setting of 70 mg/dL.
Advance warning provided by predictive low glucose alerts may further reduce hypoglycemia among rtCGM-experienced users.
可编程和固定的听觉和/或振动阈值警报是实时连续血糖监测（rtCGM）系统的基本功能，为用户在临床低血糖或高血糖发作前提供干预时间。来自 Dexcom, Inc.（G6）的第六代 rtCGM 系统包括一种新的警报，当算法预测预计血糖值≤55mg/dL 将在 20 分钟内发生时，该警报将被触发，允许用户有更多时间采取行动以避免低血糖。我们研究了这种预测性低血糖警报是否为传统低阈值警报提供了额外的益处。
我们分析了从没有预测警报的前五代系统（G5）过渡到 G6 的 1424 名患者的匿名样本中的血糖值。分别评估了低阈值警报设置为 70 或 80mg/dL 的用户。排除了使用预测性低血糖警报的接收用户、禁用预测性低血糖警报的用户或在过渡到 G6 前后 30 天内数据<30 天的用户。
与低阈值警报设置无关，过渡到 G6 后，血糖值<54、≤55、<70 和>250mg/dL 的时间百分比显著下降。低阈值警报设置为 70mg/dL 的 G6 用户的血糖达标时间有所改善。
预测性低血糖警报提供的预警可能会进一步减少经验丰富的 rtCGM 用户的低血糖发生。
