Alharbi Mohammed Y, Albunyan Abdulhameed, Al Nahari Ahmad, Al Azmi Fayez, Alenazi Badi, Al Harbi Tayba, Al Malki Matar, Al Ahmadi Husam
Therapeutic Services Deputyship, Ministry of Health, Riyadh, 11176, Kingdom of Saudi Arabia.
Pediatric Department, Maternity and Children Hospital, Al Hasa, Kingdom of Saudi Arabia.
Diabetes Ther. 2022 Jun;13(6):1139-1146. doi: 10.1007/s13300-022-01224-0. Epub 2022 Apr 20.
Measurement of glucose levels is the mainstay method of ensuring good glycemic control and preventing complications associated with uncontrolled diabetes. Continuous glucose monitoring enables easy and effective monitoring of interstitial glucose around the clock and hence improves glycemic control.
This study aimed to measure the effect of continuous glucose monitoring on glycated hemoglobin (HbA1c) at 3, 6, and 9 months following sensor insertion.
A retrospective cohort study of pediatric and adolescent type 1 diabetes mellitus patients randomly sampled from 32 Ministry of Health diabetes centers across Saudi Arabia was performed. Patients were subjected to flash glucose monitoring using the FreeStyle Libre flash glucose monitoring system (Abbott Diabetes Care, Witney, UK), an intermittently scanned continuous glucose monitoring device approved by the Conformité Européenne in 2014. These patients were first-time users of any kind of continuous glucose monitoring system, aged 4-18 years, and received insulin via multiple dose injection or continuous subcutaneous insulin infusion for at least 6 months prior to study start. Patients were excluded if they had used flash glucose monitoring or other interstitial glucose monitoring systems in the past 3 months, were pregnant, or had existing hemoglobinopathies. The flash glucose monitoring sensor was attached to the back of the upper arm at the baseline visit. HbA1c (%) was measured at baseline and 3, 6, and 9 months. Patient demographics were collected from electronic health records.
1,307 patients were included, with a mean age of 11.1 years (standard deviation 3.6 years). Where specified, 51.4% were female. Mean HbA1c significantly reduced from baseline (10.8%) to 3 months (9.8%, p < 0.001), 6 months (9.2%, p < 0.001), and 9 months (9.1%, p < 0.001). For individuals with baseline HbA1c > 9%, mean HbA1c was significantly reduced from baseline (11.7%) to 3 months (10.3%, p < 0.001), 6 months (9.6%, p < 0.001), and 9 months (9.5%, p < 0.001).
Flash glucose monitoring significantly reduced HbA1c levels at 3, 6, and 9 months following sensor insertion. This reduction was greatest in those patients with higher HbA1c at baseline (> 9%).
测量血糖水平是确保良好血糖控制和预防糖尿病控制不佳相关并发症的主要方法。持续葡萄糖监测能够全天候轻松有效地监测组织间液葡萄糖，从而改善血糖控制。
本研究旨在测量传感器插入后3个月、6个月和9个月时持续葡萄糖监测对糖化血红蛋白（HbA1c）的影响。
对从沙特阿拉伯32个卫生部糖尿病中心随机抽取的1型糖尿病儿童和青少年患者进行了一项回顾性队列研究。患者使用FreeStyle Libre闪式葡萄糖监测系统（雅培糖尿病护理公司，英国威特尼）进行闪式葡萄糖监测，这是一种2014年获得欧洲符合性认证的间歇性扫描持续葡萄糖监测设备。这些患者是首次使用任何类型持续葡萄糖监测系统的4至18岁患者，在研究开始前通过多次皮下注射胰岛素或持续皮下胰岛素输注接受胰岛素治疗至少6个月。如果患者在过去3个月内使用过闪式葡萄糖监测或其他组织间液葡萄糖监测系统、怀孕或患有现存血红蛋白病，则将其排除。在基线访视时，将闪式葡萄糖监测传感器贴在上臂背部。在基线以及3个月、6个月和9个月时测量HbA1c（%）。从电子健康记录中收集患者人口统计学数据。
纳入1307例患者，平均年龄11.1岁（标准差3.6岁）。在有具体说明的情况下，51.4%为女性。平均HbA1c从基线时的10.8%显著降至3个月时的9.8%（p<0.001）、6个月时的9.2%（p<0.001）和9个月时的9.1%（p<0.001）。对于基线HbA1c>9%的个体，平均HbA1c从基线时的11.7%显著降至3个月时的10.3%（p<0.001）、6个月时的9.6%（p<0.001）和9个月时的9.5%（p<0.001）。
闪式葡萄糖监测在传感器插入后3个月、6个月和9个月时显著降低了HbA1c水平。这种降低在基线时HbA1c较高（>9%）的患者中最为明显。
