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糖尿病患者连续血糖监测系统(CGMS)的临床和经济结果:一项系统文献综述。

Clinical and economic outcomes of continuous glucose monitoring system (CGMS) in patients with diabetes mellitus: A systematic literature review.

作者信息

Aggarwal Aditi, Pathak Smit, Goyal Richa

机构信息

Real-World Insights, Global Scientific Affairs, IQVIA, Novus Tower, Sec-18, Gurgaon, Haryana, India.

Real-World Insights, Global Scientific Affairs, IQVIA, Novus Tower, Sec-18, Gurgaon, Haryana, India.

出版信息

Diabetes Res Clin Pract. 2022 Apr;186:109825. doi: 10.1016/j.diabres.2022.109825. Epub 2022 Mar 9.

Abstract

OBJECTIVE

Poor glycemic management increases the risk of cardiac, microvascular, and other complications. Therefore, timely assessment and control of glycemic levels is paramount in diabetes. Recent advancements in automated management methods is the use of a continuous glucose monitoring system (CGMS). The objective was to study its clinical and economic impact in the glucose level monitoring and how it can be effectively used or reimbursed for wider population.

METHODS

Comprehensive search was done using multiple databases to capture relevant and most recent evidence. All steps were conducted by two independent researchers and discrepancies resolved by a third reviewer. Quality appraisal was performed by relevant scale depending on study design.

RESULTS

Twenty-six and 12 studies were included for clinical and economic outcomes, respectively. Clinical outcomes like HbA1c and glucose variation, time in range, accuracy, etc. were captured. Comparison of different CGMS types was also reported. Major economic outcomes were direct cost, healthcare resource utilization, and work absenteeism.

CONCLUSIONS

CGMS in patients with diabetes is associated with a valuable clinical implications in reducing hypoglycemic events, glucose and HbA1c level. Additionally, it has an impact on direct and indirect costs of management. Further, quantitative analysis would be required to produce concrete evidence.

摘要

目的

血糖管理不善会增加心脏、微血管及其他并发症的风险。因此,及时评估和控制血糖水平在糖尿病治疗中至关重要。自动管理方法的最新进展是使用连续血糖监测系统(CGMS)。目的是研究其在血糖水平监测中的临床和经济影响,以及如何能更有效地应用于更广泛人群或获得报销。

方法

通过多个数据库进行全面检索,以获取相关的最新证据。所有步骤均由两名独立研究人员进行,分歧由第三位评审员解决。根据研究设计,使用相关量表进行质量评估。

结果

分别纳入了26项和12项关于临床和经济结果的研究。记录了糖化血红蛋白(HbA1c)、血糖变化、血糖达标时间、准确性等临床结果。还报告了不同类型CGMS的比较情况。主要经济结果包括直接成本、医疗资源利用和旷工情况。

结论

糖尿病患者使用CGMS在减少低血糖事件、血糖和HbA1c水平方面具有重要的临床意义。此外,它还对管理的直接和间接成本产生影响。此外,还需要进行定量分析以得出具体证据。

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