Diabetes Unit, Department of Pediatrics, Faculty of Medicine, 8792Ain Shams University, Cairo, Egypt.
Division Exercise Physiology and Metabolism, Department of Sport Science, University of Bayreuth, Bayreuth, Germany.
Diab Vasc Dis Res. 2021 Nov-Dec;18(6):14791641211062155. doi: 10.1177/14791641211062155.
Early control of glycaemia is key to reduce vascular complications in individuals with Type 1 diabetes. Therefore, encouraging children and adolescents with T1DM to take responsibility for controlling glucose levels is an important yet a challenging task. The rapid expansion of continuous glucose monitoring (CGM) systems has allowed for more comprehensive analysis of glycaemia in T1D. Moreover, CGM devices have the ability to calculate rate of change in glucose levels and display the information as trend arrows. In turn, this can help to take evasive actions to return glucose levels to near physiological glycaemia, which can be highly motivating for young people with T1DM. In the absence of standardised, evidence-based guidance, this consensus document, generated by experts from the Arab Society of Paediatric Endocrinology and Diabetes and international advisors, summarises recent literature on the use of trend arrows in young people with T1DM. The use of trend arrows in different CGM systems is reviewed and their clinical significance is highlighted. Adjusting insulin doses according to trend arrows is discussed while also addressing special situations, such as exercise, fasting, nocturnal hypoglycaemia and menstruation. Adequate understanding of trend arrows should facilitate optimisation of glycaemic control in the T1D population.
早期控制血糖对于减少 1 型糖尿病患者的血管并发症至关重要。因此，鼓励 1 型糖尿病儿童和青少年承担控制血糖水平的责任是一项重要但具有挑战性的任务。连续血糖监测（CGM）系统的快速发展使得对 1 型糖尿病患者的血糖进行更全面的分析成为可能。此外，CGM 设备能够计算血糖变化率，并以趋势箭头的形式显示信息。反过来，这有助于采取规避措施，使血糖水平恢复到接近生理血糖水平，这对 1 型糖尿病的年轻人来说具有很高的激励作用。由于缺乏标准化的、基于证据的指导，这份由阿拉伯儿内分泌学会和糖尿病以及国际顾问专家撰写的共识文件总结了近期关于 1 型糖尿病青少年使用趋势箭头的文献。本文回顾了不同 CGM 系统中趋势箭头的使用，并强调了其临床意义。本文还讨论了根据趋势箭头调整胰岛素剂量的问题，同时还涉及到特殊情况，如运动、禁食、夜间低血糖和月经。充分了解趋势箭头有助于优化 1 型糖尿病患者的血糖控制。
