Gabbay Monica Andrade Lima, Rodacki Melanie, Calliari Luis Eduardo, Vianna Andre Gustavo Daher, Krakauer Marcio, Pinto Mauro Scharf, Reis Janice Sepúlveda, Puñales Marcia, Miranda Leonardo Garcia, Ramalho Ana Claudia, Franco Denise Reis, Pedrosa Hermelinda Pedrosa Cordeiro
1Diabetes Centre-UNIFESP, Federal University of São Paulo, São Paulo, Brazil.
2Nutrology and Diabetes Section, Internal Medicine Department Federal University of Rio de Janeiro-UFRJ, Rio de Janeiro, Brazil.
Diabetol Metab Syndr. 2020 Mar 16;12:22. doi: 10.1186/s13098-020-00529-z. eCollection 2020.
The International Consensus in Time in Range (TIR) was recently released and defined the concept of the time spent in the target range between 70 and 180 mg/dL while reducing time in hypoglycemia, for patients using Continuous Glucose Monitoring (CGM). TIR was validated as an outcome measures for clinical Trials complementing other components of glycemic control like Blood glucose and HbA1c. The challenge is to implement this practice more widely in countries with a limited health public and private budget as it occurs in Brazil. Could CGM be used intermittently? Could self-monitoring blood glucose obtained at different times of the day, with the amount of data high enough be used? More studies should be done, especially cost-effective studies to help understand the possibility of having sensors and include TIR evaluation in clinical practice nationwide.
国际血糖目标范围内时间(TIR)共识最近发布,为使用持续葡萄糖监测(CGM)的患者定义了血糖处于70至180mg/dL目标范围内的时间概念,同时减少低血糖时间。TIR已被确认为临床试验的一项结果指标,可补充血糖控制的其他组成部分,如血糖和糖化血红蛋白。挑战在于,像巴西这样公共和私人卫生预算有限的国家,如何更广泛地实施这一做法。CGM能否间歇性使用?一天中不同时间获取的自我血糖监测数据量足够高时,能否使用?需要开展更多研究,尤其是成本效益研究,以帮助了解使用传感器的可能性,并将TIR评估纳入全国临床实践。