Suzuki Junichi, Urakami Tatsuhiko, Yoshida Kei, Kuwabara Remi, Mine Yusuke, Aoki Masako, Morioka Ichiro
Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.
Pediatr Int. 2021 Feb;63(2):154-159. doi: 10.1111/ped.14412. Epub 2021 Feb 15.
We assessed the association between scanning frequency of flash glucose monitoring (FGM) and continuous glucose monitoring (CGM)-derived glycemic markers in children and adolescents with type 1 diabetes.
Subjects consisted of 85 children and adolescents with type 1 diabetes using FGM. We assessed the association between scanning frequencies of FGM- and CGM-derived metrics: Time in range (TIR) (70-180 mg/dL), time below range (TBR) (<70 mg/dL), time above range (>180 mg/dL), and other glycemic markers - laboratory-measured HbA1c and CGM-estimated glucose and HbA1c (eA1c) levels in the subjects.
The mean number of scans was 11.5 ± 3.5 (5-20) times per day, and scanning was most frequently conducted during a period of 18-24 h. Scanning frequency showed significant positive correlation with TIR (r = 0.719, P < 0.0001) and inverse correlation with time above range (r = -0.743, P < 0.0001), but did not correlate with TBR. There were also significant inverse correlations between scanning frequency and glucose, HbA1c, and eA1c levels (r = -0.765, -0.815, and -0.793, respectively, P < 0.0001).
Frequent glucose testing with FGM decreased hyperglycemia with increased TIR, but did not reduce TBR. Coping with a rapid fall of glucose and unexpected hypoglycemia with more advanced technology might contribute to a reduction in TBR.
我们评估了1型糖尿病儿童和青少年中闪光葡萄糖监测(FGM)的扫描频率与连续葡萄糖监测(CGM)得出的血糖指标之间的关联。
研究对象为85名使用FGM的1型糖尿病儿童和青少年。我们评估了FGM扫描频率与CGM得出的指标之间的关联:血糖达标时间(TIR)(70 - 180mg/dL)、血糖低于范围时间(TBR)(<70mg/dL)、血糖高于范围时间(>180mg/dL)以及其他血糖指标——受试者实验室测量的糖化血红蛋白(HbA1c)以及CGM估算的血糖和糖化血红蛋白(eA1c)水平。
平均扫描次数为每天11.5 ± 3.5(5 - 20)次,扫描最频繁的时间段为18 - 24小时。扫描频率与TIR呈显著正相关(r = 0.719,P < 0.0001),与血糖高于范围时间呈负相关(r = -0.743,P < 0.0001),但与TBR无相关性。扫描频率与血糖、HbA1c和eA1c水平之间也存在显著负相关(分别为r = -0.765、-0.815和-0.793,P < 0.0001)。
通过FGM频繁进行血糖检测可减少高血糖情况,使TIR增加,但并未降低TBR。采用更先进的技术应对血糖快速下降和意外低血糖情况可能有助于降低TBR。