Lin Yu Kuei, Groat Danielle, Chan Owen, Hung Man, Sharma Anu, Varner Michael W, Gouripeddi Ramkiran, Facelli Julio C, Fisher Simon J
Division of Endocrinology, Metabolism and Diabetes, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah.
J Endocr Soc. 2019 Nov 19;4(1):bvz005. doi: 10.1210/jendso/bvz005. eCollection 2020 Jan 1.
Little evidence exists regarding the positive and negative impacts of continuous glucose monitor system (CGM) alarm settings for diabetes control in patients with type 1 diabetes (T1D).
Evaluate the associations between CGM alarm settings and glucose outcomes.
A cross-sectional observational study in a single academic institution.
CGM alarm settings and 2-week CGM glucose information were collected from 95 T1D patients with > 3 months of CGM use and ≥ 86% active usage time. The associations between CGM alarm settings and glucose outcomes were analyzed.
Higher glucose thresholds for glycemia alarms (ie, ≥ 73 mg/dL vs < 73 mg/dL) were related to 51% and 65% less time with glucose < 70 and < 54 mg/dL, respectively ( = 0.005; = 0.016), higher average glucose levels ( = 0.002) and less time-in-range ( = 0.005), but not more hypoglycemia alarms. The optimal alarm threshold for < 1% of time in hypoglycemia was 75 mg/dL.Lower glucose thresholds for glycemia alarms (ie, ≤ 205 mg/dL vs > 205 mg/dL) were related to lower average glucose levels and 42% and 61% less time with glucose > 250 and > 320 mg/dL ( = 0.020, = 0.016, = 0.007, respectively), without more hypoglycemia. Lower alarm thresholds were also associated with more alarms ( < 0.0001). The optimal alarm threshold for < 5% of time in hyperglycemia and hemoglobin A1c ≤ 7% was 170 mg/dL.
Different CGM glucose thresholds for hypo/hyperglycemia alarms are associated with various hypo/hyperglycemic outcomes. Configurations to the hypo/hyperglycemia alarm thresholds could be considered as an intervention to achieve therapeutic goals.
关于连续血糖监测系统（CGM）警报设置对1型糖尿病（T1D）患者血糖控制的正负影响，现有证据较少。
评估CGM警报设置与血糖结果之间的关联。
在单一学术机构进行的横断面观察性研究。
收集了95名使用CGM超过3个月且活跃使用时间≥86%的T1D患者的CGM警报设置和2周的CGM血糖信息。分析了CGM警报设置与血糖结果之间的关联。
血糖警报的较高血糖阈值（即≥73mg/dL与<73mg/dL）分别与血糖<70和<54mg/dL的时间减少51%和65%相关（P = 0.005；P = 0.016），平均血糖水平较高（P = 0.002）且血糖在目标范围内的时间减少（P = 0.005），但低血糖警报并未增多。低血糖时间<1%的最佳警报阈值为75mg/dL。血糖警报的较低血糖阈值（即≤205mg/dL与>205mg/dL）与较低的平均血糖水平以及血糖>250和>320mg/dL的时间分别减少42%和61%相关（分别为P = 0.020、P = 0.016、P = 0.007），且低血糖情况并未增多。较低的警报阈值也与更多警报相关（P < 0.0001）。高血糖时间<5%且糖化血红蛋白A1c≤7%的最佳警报阈值为170mg/dL。
低血糖/高血糖警报的不同CGM血糖阈值与各种低血糖/高血糖结果相关。可考虑将低血糖/高血糖警报阈值的设置作为实现治疗目标的一种干预措施。
