Al Hayek Ayman A, Robert Asirvatham A, Al Dawish Mohamed A
Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Diabetes Ther. 2020 Apr;11(4):927-937. doi: 10.1007/s13300-020-00793-2. Epub 2020 Mar 7.
To study and explore the intervention of the flash glucose monitoring system (FGMS) on diabetes-related distress (DRD) in children and adolescents with type 1 diabetes (T1D).
A 12-week prospective study was performed from March 2019 to July 2019 involving 187 children and adolescents (age range 13-19 years; 56.7% female) with T1D who were self-testing their glucose levels using the conventional fingerprick method. At the time of the baseline visit, FGMS sensors were fixed by a trained diabetes educator onto each patient in the study population. A trained interviewer also administered the 28-item T1-Diabetes Distress Scale (T1-DDS) questionnaire to each participant at the baseline visit and again after 12 weeks to determine the T1-DDS score.
Comparison of the baseline (fingerprick) data with data collected at 12 weeks after the patients had switched to the FGMS revealed a significant decrease in the subdomains of the T1-DDS as follows: powerlessness (p = 0.0001); management distress (p = 0.0001); hypoglycemia distress (p = 0.0001); negative social perceptions (p = 0.0001); eating (p = 0.0001); physician distress (p = 0.0001); friend/family distress (p = 0.0001); and total T1-DDS score (p = 0.0001). Similarly, analysis of the data revealed that there was also a substantial drop from baseline to 12 weeks after initiation of the intervention in the clinical variables assessed, such as glycosylated hemoglobin; specifically, there was a considerable decrease after 12 weeks in the frequency of hypoglycemia. Interestingly, the frequency of glucose monitoring also showed an upswing among users of the FGMS.
The outcomes of this study clearly demonstrate that once the patients had been switched from the fingerprick method to FGMS, the DRD and related clinical parameters showed remarkable improvement. However, further studies are necessary to determine whether the continued and consistent use of the FGMS will achieve better results.
研究和探索动态血糖监测系统（FGMS）对1型糖尿病（T1D）儿童和青少年糖尿病相关困扰（DRD）的干预作用。
2019年3月至2019年7月进行了一项为期12周的前瞻性研究，纳入187例T1D儿童和青少年（年龄范围13 - 19岁；56.7%为女性），他们使用传统指尖采血法自行检测血糖水平。在基线访视时，由经过培训的糖尿病教育者将FGMS传感器固定在研究人群中的每位患者身上。一名经过培训的访谈者还在基线访视时以及12周后对每位参与者进行28项1型糖尿病困扰量表（T1-DDS）问卷调查，以确定T1-DDS得分。
将基线（指尖采血）数据与患者改用FGMS 12周后收集的数据进行比较，发现T1-DDS各子领域均有显著下降，具体如下：无助感（p = 0.0001）；管理困扰（p = 0.0001）；低血糖困扰（p = 0.0001）；负面社会认知（p = 0.0001）；饮食（p = 0.0001）；医生困扰（p = 0.0001）；朋友/家人困扰（p = 进行0.0001）；以及T1-DDS总分（p = 0.0001）。同样，数据分析显示，在评估的临床变量中，从基线到干预开始12周后也有大幅下降，如糖化血红蛋白；具体而言，12周后低血糖频率显著降低。有趣的是，FGMS使用者的血糖监测频率也有所上升。
本研究结果清楚地表明，一旦患者从指尖采血法改用FGMS，DRD及相关临床参数均有显著改善。然而，需要进一步研究以确定持续、稳定使用FGMS是否会取得更好的效果。
