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1型糖尿病青少年和青年开始使用动态血糖监测后血糖控制高危的初步体验——一项定性研究

Initial experiences of adolescents and young adults with type 1 diabetes and high-risk glycemic control after starting flash glucose monitoring - a qualitative study.

作者信息

Boucher Sara, Blackwell Miranda, Galland Barbara, de Bock Martin, Crocket Hamish, Wiltshire Esko, Tomlinson Paul, Rayns Jenny, Wheeler Benjamin

机构信息

Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054 New Zealand.

Department of Paediatrics, University of Otago, Floor 3, Terrace House, 4 Oxford Terrace, Christchurch, 8011 New Zealand.

出版信息

J Diabetes Metab Disord. 2019 Dec 7;19(1):37-46. doi: 10.1007/s40200-019-00472-5. eCollection 2020 Jun.

Abstract

PURPOSE

This study explored early experiences with a flash glucose monitoring system among adolescents and young adults with type 1 diabetes and high-risk glycemic control.

METHODS

Adolescents and young adults with high-risk glycemic control (HbA1c ≥ 75 mmol/mol (9.0%) in the previous 6 months) who had recently commenced on flash glucose monitoring as part of a trial took part in a semi-structured interview exploring their experiences with the technology. All interviews were recorded, transcribed and analyzed using an inductive approach.

RESULTS

Fifteen interviews were conducted. Overall, participants enjoyed flash glucose monitoring and planned to continue using their system. Key findings included flash glucose monitoring reduced diabetes management burden and increased glucose monitoring. Other impacts of flash glucose monitoring use included perceived improved mood and energy, increased capacity for physical activity and less parental conflict. While participants reported healthier glycemic control, participants' mean interstitial glucose level remained above the target range of 3.9-10.0 mmol/L (70-180 mg/dL) over the first month of flash glucose monitoring. Common challenges included premature sensor loss and decreased scanning over the first month of use.

CONCLUSIONS

Flash glucose monitoring may be an acceptable self-management tool to increase monitoring frequency in adolescents and young adults with type 1 diabetes and high-risk glycemic control, with the potential to improve long-term glycemic control. Initial support efforts should focus on practical strategies to prolong sensor wear and motivate frequent scanning as well as education on interpreting glucose data and making informed treatment decisions to maximize the benefits of this technology.

摘要

目的

本研究探讨了1型糖尿病及血糖控制高危的青少年和青年使用动态血糖监测系统的早期体验。

方法

作为一项试验的一部分,近期开始使用动态血糖监测的血糖控制高危(过去6个月糖化血红蛋白≥75 mmol/mol [9.0%])的青少年和青年参加了一项半结构化访谈,探讨他们对该技术的体验。所有访谈均进行录音、转录,并采用归纳法进行分析。

结果

共进行了15次访谈。总体而言,参与者喜欢动态血糖监测并计划继续使用该系统。主要发现包括动态血糖监测减轻了糖尿病管理负担并增加了血糖监测次数。使用动态血糖监测的其他影响包括感觉情绪和精力改善、身体活动能力增强以及亲子冲突减少。虽然参与者报告血糖控制更健康,但在动态血糖监测的第一个月,参与者的平均组织间液葡萄糖水平仍高于3.9 - 10.0 mmol/L(70 - 180 mg/dL)的目标范围。常见挑战包括传感器过早丢失以及在使用的第一个月扫描次数减少。

结论

动态血糖监测可能是一种可接受的自我管理工具,可增加1型糖尿病及血糖控制高危的青少年和青年的监测频率,有可能改善长期血糖控制。初步支持措施应侧重于延长传感器佩戴时间和激励频繁扫描的实用策略,以及关于解读血糖数据和做出明智治疗决策的教育,以最大限度地发挥该技术的益处。

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