Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, United Kingdom.
Diabetes Technol Ther. 2020 Mar;22(3):235-238. doi: 10.1089/dia.2019.0369.
Current intermittently scanned continuous glucose monitoring (isCGM) devices do not allow calibration and require confirmatory self-monitored blood glucose (SMBG) under specific defined conditions. The overall time spent in an SMBG-indicated state while using isCGM has not been reported in the existing literature. We present the time spent in an SMBG-indicated state and the daily number of transitions to an SMBG-indicated state during isCGM use in a high-risk cohort of adults with type 1 diabetes. This is a post hoc analysis of participants randomized to isCGM as part of a clinical study. The percentage of values meeting one or more of the criteria for SMBG testing (hours per day) and the number of transitions to an SMBG-indicated state per day were calculated according to the manufacturer's label in the United Kingdom. Complete data sets for 20 participants on isCGM for 8 weeks were included in the analysis. Participants spent a mean (SD) of 5.61 (1.81) h/day in an SMBG-indicated state and there were 5.43 (1.42) transitions to an SMBG-indicated state per day while using isCGM. These findings have important implications for cost-effectiveness and for decision-making around insulin dose calculations and driving. Our findings emphasize the need for continued SMBG testing among people at high risk of hypoglycemia who use isCGM. Cost-effectiveness analyses for isCGM may require revision.
目前的间歇性扫描连续血糖监测(isCGM)设备不允许校准,并且需要在特定的定义条件下进行确认性自我监测血糖(SMBG)。在使用 isCGM 时,处于 SMBG 指示状态的总时间尚未在现有文献中报道。我们介绍了在高危 1 型糖尿病成人患者中使用 isCGM 时处于 SMBG 指示状态的时间和每天进入 SMBG 指示状态的次数。这是一项针对随机分配至 isCGM 作为临床研究一部分的参与者的事后分析。根据英国制造商的标签,计算了符合 SMBG 检测标准(每天小时数)的一个或多个标准的百分比和每天进入 SMBG 指示状态的次数。在分析中,共有 20 名参与者完成了 8 周的 isCGM 完整数据集。参与者在 SMBG 指示状态下平均(SD)花费 5.61(1.81)小时/天,每天有 5.43(1.42)次过渡到 SMBG 指示状态。这些发现对成本效益以及围绕胰岛素剂量计算和驾驶的决策具有重要意义。我们的发现强调了在使用 isCGM 的低血糖高风险人群中继续进行 SMBG 测试的必要性。可能需要对 isCGM 的成本效益分析进行修订。