Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Nakakinen Clinic, Ibaraki, Japan.
J Diabetes Investig. 2021 Jan;12(1):82-90. doi: 10.1111/jdi.13327. Epub 2020 Sep 9.
AIMS/INTRODUCTION: We investigated the effect of FreeStyle Libre on glycemic control in Japanese type 2 diabetes patients treated with basal-bolus insulin therapy.
This prospective, 90-day single-arm study enrolled 94 adults with type 2 diabetes treated with insulin. A 14-day masked baseline phase was followed by an 11-week treatment phase during which participants used the device to monitor glucose levels. The primary end-point was time spent in hypoglycemia (<70 mg/dL) for baseline versus study end (days 76-90). Secondary end-points included other measures of glycemic control, along with patient satisfaction using the Japanese Diabetes Treatment and Satisfaction Questionnaire.
Time spent in hypoglycemia was low at baseline (0.51 ± 0.93 h/day) and did not significantly decrease at study end (0.47 ± 0.63 h/day, P = 0.6354). Time in range, time in hyperglycemia and estimated A1c all improved versus baseline (by +1.7 ± 3.0 h/day, -1.6 ± .4 h/day and -0.4 ± 0.8%, respectively, P < 0.0001 in each). Finger stick tests fell from 2.9 ± 1.3 to 1.9 ± 1.4/day, and mean scanning frequency during the intervention phase was 11.3/day. The mean treatment satisfaction score increased by 11.8 ± 5.3 (P < 0.0001). Two severe hypoglycemia-related adverse events were reported; one of which was possibly related to the device. Three participants reported mild device-related skin trauma, site discomfort or subcutaneous bleeding.
Use of FreeStyle Libre by Japanese type 2 patients diabetes treated with basal-bolus insulin therapy showed a low baseline of hypoglycemia, and enabled improved glycemic control and treatment satisfaction.
目的/引言:我们研究了 FreeStyle Libre 在接受基础-餐时胰岛素治疗的日本 2 型糖尿病患者中的血糖控制效果。
这项前瞻性、90 天的单臂研究纳入了 94 名接受胰岛素治疗的 2 型糖尿病成年患者。在为期 14 天的盲法基线期后,进行了为期 11 周的治疗期,在此期间参与者使用该设备监测血糖水平。主要终点是基线期与研究结束时(第 76-90 天)的低血糖时间(<70mg/dL)。次要终点包括其他血糖控制指标,以及使用日本糖尿病治疗和满意度问卷评估的患者满意度。
基线期的低血糖时间较低(0.51±0.93 小时/天),研究结束时无显著下降(0.47±0.63 小时/天,P=0.6354)。时间在目标范围内、高血糖时间和估计的 A1c 均较基线改善(分别增加 1.7±3.0 小时/天、-1.6±0.4 小时/天和-0.4±0.8%,P<0.0001)。指尖血糖检测次数从 2.9±1.3 次/天降至 1.9±1.4 次/天,干预期间的平均扫描频率为 11.3 次/天。治疗满意度评分平均增加 11.8±5.3(P<0.0001)。报告了 2 例严重低血糖相关不良事件,其中 1 例可能与设备相关。3 名参与者报告了轻微的设备相关皮肤创伤、部位不适或皮下出血。
接受基础-餐时胰岛素治疗的日本 2 型糖尿病患者使用 FreeStyle Libre 可使低血糖的基线水平较低,并改善血糖控制和治疗满意度。