Katayama Akihiro, Tone Atsuhito, Watanabe Mayu, Teshigawara Sanae, Miyamoto Satoshi, Eguchi Jun, Nakatsuka Atsuko, Shikata Kenichi, Wada Jun
1Diabetes Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558 Japan.
2Diabetes Center, Okayama Saiseikai General Hospital, Kita-ku, Okayama, 700-8511 Japan.
Diabetol Int. 2019 Sep 16;11(2):97-104. doi: 10.1007/s13340-019-00408-7. eCollection 2020 Apr.
AIMS/INTRODUCTION: The predictive low glucose management (PLGM) system was introduced in March 2018 in Japan. Although there are some reports demonstrating the benefit of PLGM in preventing hypoglycemia, no data are currently available in Japanese patients with type 1 diabetes mellitus (T1DM). The aim of the present study is to evaluate the effect of PLGM with sensor-augmented pump therapy in the prevention of hypoglycemia in Japanese patients.
We included 16 patients with T1DM who used the MiniMed640G system after switching from the MiniMed620G system. We retrospectively analysed the data of the continuous glucose monitoring system in 1 month after switching to MiniMed640G.
The area under the curve (AUC) of hypoglycemia of < 70 mg/dL was lowered from 0.42 ± 0.43 mg/dL day to 0.18 ± 0.18 mg/dL day ( = 0.012). Correspondingly, the duration of severe hypoglycemia (< 54 mg/dL) was reduced significantly from 15.3 ± 21.7 min/day to 4.8 ± 6.9 min/day ( = 0.019). The duration of hypoglycemia was reduced, but the reduction was not significant. Regarding the AUC for hyperglycemia > 180 mg/dL and the duration of hyperglycemia did not change. With the PLGM function, 79.3% of the predicted hypoglycemic events were avoided.
The hypoglycemia avoidance rate was comparable to those in previous reports. In addition, we demonstrated that PLGM can markedly suppress severe hypoglycemia without deteriorating glycemic control in Japanese T1DM patients. It is necessary to further investigate the effective use of the PLGM feature such as establishing a lower limit and the timing of resumption.
目的/引言:预测性低血糖管理(PLGM)系统于2018年3月在日本推出。尽管有一些报告表明PLGM在预防低血糖方面有益处,但目前尚无关于日本1型糖尿病(T1DM)患者的数据。本研究的目的是评估PLGM联合传感器增强型泵疗法在预防日本T1DM患者低血糖方面的效果。
我们纳入了16例从MiniMed620G系统转换为使用MiniMed640G系统的T1DM患者。我们回顾性分析了转换为MiniMed640G后1个月内连续血糖监测系统的数据。
低血糖(<70mg/dL)的曲线下面积(AUC)从0.42±0.43mg/dL·天降至0.18±0.18mg/dL·天(P=0.012)。相应地,严重低血糖(<54mg/dL)的持续时间从15.3±21.7分钟/天显著减少至4.8±6.9分钟/天(P=0.019)。低血糖持续时间有所减少,但减少不显著。关于血糖>180mg/dL的AUC和高血糖持续时间没有变化。通过PLGM功能,79.3%的预测低血糖事件得以避免。
低血糖避免率与先前报告中的相当。此外,我们证明了PLGM可以显著抑制严重低血糖,而不会恶化日本T1DM患者的血糖控制。有必要进一步研究PLGM功能的有效使用,如设定下限和恢复时间。