Fraser River Endocrinology, Vancouver, BC, Canada; University of British Columbia, Vancouver, BC, Canada.
Diabetes Metab Syndr. 2021 May-Jun;15(3):703-709. doi: 10.1016/j.dsx.2021.03.011. Epub 2021 Mar 20.
BACKGROUND/AIMS: To assess the efficacy of a novel interim intervention technique using retrospective, blinded, professional continuous glucose monitoring system (pro CGM) with the Freestyle Libre Pro system over a 14-day single sensor wear-period.
A retrospective analysis comprised of 105 consecutive adults at single centre in India with Type 2 diabetes, HbA1c > 53 mmol/mol (>7%), on non-insulin divabetes agents and/or insulin. The interim intervention technique included three visits over 14 days: Visit 1, sensor placed and patients asked to keep a food log while on pro-CGM; Visit 2 (within 1 week), interim assessment of pro CGM and diet or pharmacotherapy modifications made accordingly; Visit 3 at day 14, pro CGM re-evaluated to assess glycemic control. Glucose target range was set at 70-180 mg/dL. Analyses included pre & post daily average glucose, time in range, time above range, and time below range.
Average time for interim analysis was 5 days after pro CGM initiation. At Visit 3, daily average glucose decreased from 191.3 mg/dL at baseline to 137.4 mg/dL (p < 0.001). Time in range improved from 42.2% to 80.2% (p < 0.001). Time above range decreased from 52.1% to 18.3% (p < 0.001), with a concurrent decrease in time below range from 5.7% to 1.5% (p < 0.001). Recurrent hypoglycemia was detected in 27 (25.7%) individuals, whose average baseline time below range reduced from 21.1% to 1.9% (p < 0.001).
The interim intervention technique is a cost effective and efficient method for improving glucose outcomes through lifestyle and pharmacotherapy modifications and while utilizing a single pro-CGM sensor.
Wockhardt Hospital, Mumbai, India. CLINICAL REGISTRATION: not applicable due to retrospective chart review study design.
背景/目的：评估在 14 天的单次传感器佩戴期内使用新型临时干预技术，使用回顾性、盲法、专业连续血糖监测系统（pro CGM）与 Freestyle Libre Pro 系统的疗效。
在印度单一中心的 105 例连续 2 型糖尿病成人患者中进行了回顾性分析，这些患者的 HbA1c>53mmol/mol（>7%），正在接受非胰岛素糖尿病药物和/或胰岛素治疗。临时干预技术包括 14 天内的三次就诊：就诊 1，放置传感器，同时要求患者在 pro-CGM 期间记录饮食日志；就诊 2（1 周内），根据 pro CGM 和饮食或药物治疗的评估进行干预；就诊 3 在第 14 天，重新评估 pro CGM 以评估血糖控制情况。葡萄糖目标范围设定为 70-180mg/dL。分析包括治疗前后的平均每日血糖、血糖达标时间、血糖高于目标范围时间和血糖低于目标范围时间。
pro CGM 开始后平均 5 天进行临时分析。就诊 3 时，患者的平均每日血糖从基线时的 191.3mg/dL 降至 137.4mg/dL（p<0.001）。血糖达标时间从 42.2%提高到 80.2%（p<0.001）。血糖高于目标范围时间从 52.1%降至 18.3%（p<0.001），同时血糖低于目标范围时间从 5.7%降至 1.5%（p<0.001）。27 例（25.7%）患者出现复发性低血糖，其平均基线时间低于目标范围时间从 21.1%降至 1.9%（p<0.001）。
通过生活方式和药物治疗的改变，以及利用单个 pro-CGM 传感器，临时干预技术是一种具有成本效益和效率的方法，可以改善血糖结果。
印度孟买的 Wockhardt 医院。临床注册：由于回顾性图表审查研究设计，不适用。
