Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.
J Diabetes Investig. 2022 Oct;13(10):1745-1752. doi: 10.1111/jdi.13830. Epub 2022 May 28.
AIMS/INTRODUCTION: The aim of the study was to compare two continuous glucose monitoring (CGM) systems, intermittently scanned CGM (isCGM) and real-time CGM (rtCGM), to determine which system achieved better glycemic control in pediatric patients.
We carried out a retrospective cohort study of children and adolescents with type 1 diabetes, and compared the time in range (70-180 mg/dL), time below range (<70 mg/dL) and time above range (>180 mg/dL), and estimated glycated hemoglobin levels between patients on isCGM and rtCGM.
Of the 112 participants, 76 (67.9%) used isCGM and 36 (32.1%) used rtCGM for glycemic management. Patients on rtCGM had significantly greater time in range (57.7 ± 12.3% vs 52.3 ± 12.3%, P = 0.0368), and had significantly lower time below range (4.3 ± 2.7% vs 10.2% ± 5.4%, P < 0.001) than those on isCGM, but there was no significant difference in the time above range (37.4 ± 12.9% vs 38.0% ± 12.5%, P = 0.881) or the glycosylated hemoglobin A1c levels (7.4 ± 0.9% vs 7.5 ± 0.8%, P = 0.734) between the two groups.
Pediatric patients with type 1 diabetes on rtCGM also showed more beneficial effects for increase of time in range, with a notable reduction of time below range compared with those on isCGM. Real-time CGM might provide better glycemic control than isCGM in children with type 1 diabetes.
目的/引言:本研究旨在比较两种连续血糖监测(CGM)系统,即间歇性扫描 CGM(isCGM)和实时 CGM(rtCGM),以确定哪种系统在儿科患者中能实现更好的血糖控制。
我们对 112 名 1 型糖尿病儿童和青少年进行了回顾性队列研究,比较了使用 isCGM 和 rtCGM 的患者的达标时间(70-180mg/dL)、血糖低于目标值时间(<70mg/dL)、血糖高于目标值时间(>180mg/dL)以及糖化血红蛋白水平。
在 112 名参与者中,76 名(67.9%)使用 isCGM,36 名(32.1%)使用 rtCGM 进行血糖管理。与 isCGM 相比,使用 rtCGM 的患者达标时间显著增加(57.7±12.3% vs 52.3±12.3%,P=0.0368),血糖低于目标值时间显著减少(4.3±2.7% vs 10.2%±5.4%,P<0.001),但血糖高于目标值时间(37.4±12.9% vs 38.0%±12.5%,P=0.881)和糖化血红蛋白 A1c 水平(7.4±0.9% vs 7.5±0.8%,P=0.734)无显著差异。
与 isCGM 相比,使用 rtCGM 的 1 型糖尿病儿科患者的达标时间增加更明显,血糖低于目标值的时间显著减少,提示 rtCGM 可能比 isCGM 更能控制儿童 1 型糖尿病患者的血糖。