Kaiser Permanente-Division of Research, Oakland, California, USA.
Kaiser Permanente Northern California, South San Francisco, California, USA.
Diabetes Technol Ther. 2022 May;24(5):332-337. doi: 10.1089/dia.2021.0450. Epub 2022 Feb 18.
Continuous glucose monitoring (CGM) is indicated in poorly controlled insulin-treated patients with type 2 diabetes (T2D) to improve glycemic control and reduce the risk of hypoglycemia, but the benefits of CGM for lower risk patients have not been well studied. Among 17,422 insulin-treated patients with T2D with hemoglobin A1c (HbA1c) <8% and no recent severe hypoglycemia (based on emergency room visits or hospitalizations), CGM initiation occurred in 149 patients (17,273 noninitiators served as reference). Changes in HbA1c and severe hypoglycemia rates for the 12 months before and after CGM initiation were calculated. CGM initiation was associated with decreased HbA1c (-0.06%), whereas noninitiation was associated with increased HbA1c (+0.32%); a weighted adjusted difference-in-difference model of change in HbA1c yielded a net benefit of -0.30%; 95% CI -0.50%, -0.10%; = 0.004). No significant differences were observed for severe hypoglycemia. CGM may be useful in preventing glycemic deterioration in well-controlled patients with insulin-treated T2D.
持续血糖监测（CGM）适用于 2 型糖尿病（T2D）接受胰岛素治疗但血糖控制不佳的患者，以改善血糖控制并降低低血糖风险，但 CGM 对低风险患者的益处尚未得到充分研究。在 17422 名糖化血红蛋白（HbA1c）<8%且近期无严重低血糖（根据急诊就诊或住院情况）的接受胰岛素治疗的 T2D 患者中，149 名患者开始使用 CGM（17273 名未开始使用 CGM 的患者作为对照）。计算了 CGM 开始前后 12 个月的 HbA1c 和严重低血糖发生率变化。CGM 起始与 HbA1c 降低（-0.06%）相关，而不起始与 HbA1c 升高（+0.32%）相关；HbA1c 变化的加权调整差异模型产生了 0.30%的净获益；95%CI -0.50%，-0.10%；=0.004）。严重低血糖无显著差异。CGM 可能有助于预防血糖控制良好的接受胰岛素治疗的 T2D 患者的血糖恶化。
