Endocrinology and Nutrition Department. Badajoz University Hospital, Badajoz, Spain.
Endocrinology and Nutrition Department. Badajoz University Hospital, Badajoz, Spain.
Nutr Metab Cardiovasc Dis. 2021 Jun 7;31(6):1845-1850. doi: 10.1016/j.numecd.2021.02.028. Epub 2021 Mar 3.
Several treatment modalities are available for type 1 diabetes (T1D), including continuous glucose monitoring (CGM) and flash glucose monitoring (FGM) with MDI, sensor-augmented pumps with predictive low-glucose suspend function (SAP-PLGS) and hybrid closed-loop systems (HCL). The aim of the study was to evaluate the real-world benefits obtained with these treatment modalities.
A cross-sectional study was performed, selecting 4 groups of T1D subjects, regarding their treatment modalities, paired by age, sex and diabetes duration. A comparison was performed, concerning time in different glucose ranges in 2-week sensor downloads. Estimated HbA1c, glycaemic variability measures and sensor use were also compared. 302 T1D people were included (age: 39 ± 12 years, 47% male, diabetes duration: 21 ± 10 years, estimated HbA1c: 7.28 ± 0.84% (56 ± 9 mmol/mol), baseline HbA1c: 7.4 ± 1.0% (57 ± 11 mmol/mol), length of use of the device 8 [3-21] months). Group 1 (CGM + MDI) and 2 (FGM + MDI) showed no differences in time in different glucose ranges. Group 4 (HCL) showed a higher time 70-180 mg/dl and a lower time in hypoglycaemia than group 3 (SAP-PLGS). Group 1 and 2 showed lower time 70-180 mg/dl, higher time in hyperglycaemia and higher glycaemic variability measures than group 3. Group 4 was superior to groups 1 and 2 in all the outcomes.
Real-life achievements in glycaemic control and glycaemic variability are described. HCL offer the maximum benefit in terms of time in range and hypoglycaemia protection, compared to CGM + MDI, FGM + MDI and SAP-PLGS.
1 型糖尿病（T1D）有多种治疗方法，包括连续血糖监测（CGM）和基于 MDI 的瞬感血糖监测（FGM）、具有预测性低血糖暂停功能的传感器增强型泵（SAP-PLGS）和混合闭环系统（HCL）。本研究旨在评估这些治疗方法的实际获益。
本研究采用了一项横断面研究，根据治疗方法将 4 组 T1D 患者分为年龄、性别和糖尿病病程相匹配的两组。比较了两周内传感器下载时不同血糖范围内的时间分布。还比较了估计的糖化血红蛋白（HbA1c）、血糖变异性指标和传感器使用情况。共纳入 302 名 T1D 患者（年龄：39±12 岁，47%为男性，糖尿病病程：21±10 年，估计的 HbA1c：7.28±0.84%（56±9mmol/mol），基线 HbA1c：7.4±1.0%（57±11mmol/mol），设备使用时长 8[3-21]个月）。组 1（CGM+MDI）和组 2（FGM+MDI）在不同血糖范围内的时间无差异。组 4（HCL）在 70-180mg/dl 血糖范围内的时间更长，低血糖时间更短，而组 3（SAP-PLGS）则相反。组 1 和组 2 的 70-180mg/dl 血糖范围内的时间更短，高血糖时间更长，血糖变异性指标更高。与组 1 和组 2 相比，组 4 在所有结果上均具有优势。
描述了在血糖控制和血糖变异性方面的实际成果。与 CGM+MDI、FGM+MDI 和 SAP-PLGS 相比，HCL 在血糖达标时间和低血糖保护方面具有最大获益。
