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丹麦 COVID-19 大流行期间隔离住院患者的远程连续血糖监测:一项随机对照探索性试验。

Telemetric Continuous Glucose Monitoring During the COVID-19 Pandemic in Isolated Hospitalized Patients in Denmark: A Randomized Controlled Exploratory Trial.

机构信息

Department of Endocrinology and Nephrology, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark.

Department of Pulmonary and Infectious Diseases, and Copenhagen University Hospital - North Zealand, Hilleroed, Denmark.

出版信息

Diabetes Technol Ther. 2022 Feb;24(2):102-112. doi: 10.1089/dia.2021.0291. Epub 2022 Jan 4.

Abstract

To investigate whether telemetric continuous glucose monitoring (CGM) in hospitalized and isolated patients with diabetes mellitus and coronavirus disease 2019 (COVID-19) is associated with better glycemic outcomes and fewer patient health care worker contacts compared to blood glucose monitoring by traditional point-of-care (POC) glucose testing and to investigate the user aspect of implementing a CGM-system in-hospital. A randomized controlled exploratory trial was performed on hospitalized and isolated patients with diabetes and COVID-19 from May 2020 until February 2021 at Nordsjællands Hospital, Denmark. Participants were randomized to nonblinded telemetric CGM (as the only glucose monitoring method) or traditional POC glucose testing + blinded CGM. The primary endpoint was time in range (TIR) based on CGM data in both groups. A questionnaire about the user aspect of the CGM system was answered by health care personnel (HCP). We included 64 participants in the analysis, 31 in the CGM group and 33 in the POC glucose group. TIR median was 46% for the CGM group and 68% for the POC glucose group ( = 0.368). The mean glucose value for the CGM group was 11.1 and 10.8 mmol/L in the POC glucose group ( = 0.372). CGM was associated with fewer POC glucose measurements ( < 0.001). Out of 30 HCPs, 28 preferred telemetric CGM over POC glucose testing. Remote glucose monitoring by CGM did not improve glycemic outcomes compared to traditional POC glucose testing, but was associated with fewer patient-personnel contacts, saving time for HCPs performing diabetes-related tasks. Most HCPs preferred CGM. The study is registered at http://www.clinicaltrials.gov (#NCT04430608).

摘要

研究目的

探讨与传统即时检测(POC)血糖仪相比,遥测连续血糖监测(CGM)在患有糖尿病和 2019 年冠状病毒病(COVID-19)的住院和隔离患者中是否能更好地控制血糖,减少患者与医护人员的接触。

方法

这是一项于 2020 年 5 月至 2021 年 2 月在丹麦北日德兰医院进行的针对患有糖尿病和 COVID-19 的住院和隔离患者的随机对照探索性试验。参与者被随机分为非盲遥测 CGM(作为唯一的血糖监测方法)或传统 POC 血糖仪+盲法 CGM。主要终点是两组基于 CGM 数据的时间在目标范围内(TIR)。医护人员(HCP)回答了关于 CGM 系统使用方面的问卷。

结果

我们共纳入了 64 名参与者进行分析,CGM 组 31 人,POC 葡萄糖组 33 人。CGM 组的 TIR 中位数为 46%,POC 葡萄糖组为 68%(P=0.368)。CGM 组的平均血糖值为 11.1mmol/L,POC 葡萄糖组为 10.8mmol/L(P=0.372)。CGM 组的 POC 血糖测量次数明显少于 POC 葡萄糖组(P<0.001)。在 30 名 HCP 中,有 28 人更喜欢 CGM 遥测,而不是 POC 血糖仪。

结论

与传统的 POC 血糖监测相比,CGM 远程血糖监测并未改善血糖控制结果,但与减少患者与医务人员的接触有关,为执行与糖尿病相关任务的 HCP 节省了时间。大多数 HCP 更喜欢 CGM。该研究已在 http://www.clinicaltrials.gov 注册(#NCT04430608)。

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