Nemours Children's Hospital, Orlando, FL, USA.
University of Central Florida, College of Medicine, Orlando, FL, USA.
J Pediatr Endocrinol Metab. 2021 Feb 23;34(3):311-317. doi: 10.1515/jpem-2020-0587. Print 2021 Mar 26.
The development of continuous glucose monitoring (CGM) systems has allowed for identification of blood sugar variations and trends in real-time that is not feasible with conventional self-monitoring of blood glucose. However, there is inconsistent data to show that the use of CGM leads to better glycemic control as measured by Hemoglobin A1c (HbA1c) in pediatric patients with type 1 diabetes mellitus. Our study aimed to compare the average HbA1c level in the 1-2 years prior to starting a CGM to the average HbA1c level in the 1-2 years immediately following CGM initiation in a sample of 1-20 year olds with type 1 diabetes mellitus.
Participants were 90 youth (ages 1-20) followed for type 1 diabetes care at our institution who used a CGM for at least a 6 month time period. We performed a retrospective chart review to obtain up to four HbA1c values pre and post-CGM initiation each. We evaluated pre- and post-CGM initiation changes in mean HbA1c via dependent samples t-tests using IBM SPSS 24.0.
The mean HbA1c was 8.7% pre-CGM and decreased to 8.27% 9-12 months after CGM initiation in the overall sample. A statistically significant decrease in HbA1c was seen in patients who used multiple daily injections (p=0.02), those with a pre-CGM HbA1c greater than 9% (p=0.01), and those with a diabetes duration of 5-10 years (p=0.02).
CGM use was associated with a decrease in HbA1c over time which was statistically significant in some subgroups.
连续血糖监测（CGM）系统的发展使得实时识别血糖变化和趋势成为可能，这是传统自我监测血糖所无法实现的。然而，目前的数据并不一致，无法表明 CGM 的使用会导致 1 型糖尿病患儿的糖化血红蛋白（HbA1c）得到更好的控制。我们的研究旨在比较一组 1 至 20 岁的 1 型糖尿病患者在开始使用 CGM 的前 1-2 年和开始使用 CGM 的后 1-2 年的平均 HbA1c 水平。
本研究共纳入了 90 名在我院接受 1 型糖尿病治疗的青少年（年龄 1-20 岁），他们至少使用 CGM 监测了 6 个月。我们通过回顾性病历审查获得了每个患者在开始使用 CGM 前后最多 4 次的 HbA1c 值。我们使用 IBM SPSS 24.0 进行了依赖样本 t 检验，评估了 CGM 开始前后 HbA1c 的均值变化。
总体样本中，CGM 开始前的平均 HbA1c 为 8.7%，在开始使用 CGM 后 9-12 个月降至 8.27%。在使用多次每日注射（p=0.02）、CGM 开始前 HbA1c 大于 9%（p=0.01）和糖尿病病程为 5-10 年的患者中（p=0.02），HbA1c 显著降低。
CGM 的使用与 HbA1c 的下降有关，在某些亚组中具有统计学意义。
