De Ridder Francesca, den Brinker Marieke, De Block Christophe
University of Antwerp, Faculty of Medicine & Health Sciences, Laboratory of Experimental Medicine and Pediatrics (LEMP), Antwerp, Belgium.
Antwerp University Hospital, Department of Paediatrics, Antwerp, Belgium.
Ther Adv Endocrinol Metab. 2019 Jul 25;10:2042018819865399. doi: 10.1177/2042018819865399. eCollection 2019.
Managing type 1 diabetes (T1DM) is challenging and requires intensive glucose monitoring and titration of insulin in order to reduce the risk of complications. The use of continuous glucose monitoring (CGM) systems, either flash or intermittently scanned glucose monitoring (isCGM) or real-time (RT) CGM, has positively affected the management of type 1 diabetes with the potential to lower HbA1c, enhance time spent in range, reduce frequency and time spent in hypoglycemia and hyperglycemia, lower glycemic variability, and improve quality of life. In recent years, both CGM and pump technology have advanced, with improved functional features and integration, including low glucose suspend (LGS), predictive low glucose suspend (PLGS), and hybrid closed-loop (HCL) systems. In this review, we highlight the benefits and limitations of use of isCGM/RT-CGM for open-loop control and recent progress in closed-loop control systems. We also discuss different subject profiles for the different systems, and focus on educational aspects that are key to successful use of the systems.
管理1型糖尿病（T1DM）具有挑战性，需要进行强化血糖监测和胰岛素滴定，以降低并发症风险。使用持续葡萄糖监测（CGM）系统，无论是闪光型还是间歇性扫描葡萄糖监测（isCGM）或实时（RT）CGM，都对1型糖尿病的管理产生了积极影响，有可能降低糖化血红蛋白（HbA1c）水平、增加血糖处于目标范围内的时间、减少低血糖和高血糖的发生频率及持续时间、降低血糖变异性并改善生活质量。近年来，CGM和胰岛素泵技术都有了进步，功能特性和集成性得到改善，包括低血糖暂停（LGS）、预测性低血糖暂停（PLGS）和混合闭环（HCL）系统。在本综述中，我们强调了使用isCGM/RT-CGM进行开环控制的益处和局限性，以及闭环控制系统的最新进展。我们还讨论了不同系统适用的不同受试者特征，并重点关注成功使用这些系统的关键教育方面。
