贯穿一生的 1 型糖尿病患者对连续血糖监测使用的感知负担和获益。
Perceived Burdens and Benefits Associated With Continuous Glucose Monitor Use in Type 1 Diabetes Across the Lifespan.
机构信息
Department of Medicine, Upstate Medical University, Syracuse NY, USA.
Public Health and Preventive Medicine, Upstate Medical University, Syracuse, NY, USA.
出版信息
J Diabetes Sci Technol. 2022 Jan;16(1):88-96. doi: 10.1177/1932296820978769. Epub 2020 Dec 24.
BACKGROUND
Continuous glucose monitors (CGMs) help people with type 1 diabetes (T1D) improve their glycemic profiles but are underutilized. To better understand why, perceived CGM burdens and benefits in nonusers versus users with type 1 diabetes across the lifespan were assessed.
METHODS
Burdens (BurCGM) and benefits of CGM (BenCGM) questionnaires were completed during T1D outpatient visits ( = 1334) from February 2019 to February 2020. Mean scores were calculated (scale one to five; higher scores reflect greater perceived burdens/benefits). Data were collected from medical records including glycated hemoglobin (HbA1c) within 3 months of the visit.
RESULTS
Individuals of all ages using CGM described more benefits and less burdens (mean scores 4.48 and 1.69, respectively) when compared with those who were not using CGM (mean score 4.19 and 2.35, respectively) ( < .001). There were no differences in burdens or benefits by sex. Non-CGM users aged ≥50 years had higher mean BurCGM scores than those aged <50 years ( = .004); the cost was the greatest barrier in those aged 27+ years. Other burdens were readings not trusted, painful to wear, and takes too much time to use. For those aged 65+, nonusers versus users, 18.5% versus 3.1% agreed with "it was too hard to understand CGM information," and 21.4% versus 7.7% agreed that CGM causes too much worry. Mean HbA1C was lower in CGM users (8.1%) versus non-CGM users (mean A1c 9.1%; < .001).
CONCLUSIONS
CGM was perceived as having more burdens and less benefits in nonusers, with differences in concerns varying across the lifespan. Lower costs and age-appropriate education are needed to address these barriers.
背景
连续血糖监测仪（CGM）有助于改善 1 型糖尿病（T1D）患者的血糖水平，但使用率较低。为了更好地理解原因，评估了不同年龄段 T1D 患者中未使用与使用 CGM 的患者对 CGM 的负担和获益的感知。
方法
在 2019 年 2 月至 2020 年 2 月期间，通过 T1D 门诊就诊收集了 CGM 负担（BurCGM）和获益（BenCGM）问卷（ = 1334）。计算平均得分（一到五分；得分越高，表明感知负担/获益越大）。数据来自病历，包括就诊前 3 个月的糖化血红蛋白（HbA1c）。
结果
与未使用 CGM 的患者相比，所有年龄段使用 CGM 的患者均描述了更多的获益和更少的负担（分别为 4.48 分和 1.69 分），而未使用 CGM 的患者分别为 4.19 分和 2.35 分（<0.001）。性别对负担或获益无影响。≥50 岁的非 CGM 用户的 BurCGM 平均得分高于<50 岁的患者（ =.004）；对 27 岁及以上的患者来说，费用是最大的障碍。其他负担包括读取结果不可信、佩戴疼痛和使用时间过长。对于 65 岁以上的患者，非使用者与使用者相比，18.5%与 3.1%认为“CGM 信息太难理解”，21.4%与 7.7%认为 CGM 导致过多担忧。CGM 用户的平均 HbA1C 低于非 CGM 用户（CGM 为 8.1%，非 CGM 为 9.1%；<0.001）。
结论
未使用者认为 CGM 的负担更大，获益更小，不同年龄段的担忧点存在差异。需要降低成本和提供适合年龄的教育，以解决这些障碍。
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