Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Ulm, Germany.
German Centre for Diabetes Research (DZD), München-Neuherberg, Germany.
Diabetes Technol Ther. 2022 Oct;24(10):763-769. doi: 10.1089/dia.2022.0063. Epub 2022 Jul 8.
Continuous glucose monitoring (CGM) might have beneficial effects on glycemic control and body mass index (BMI) in adults with type 1 (T1D) or type 2 diabetes (T2D). The diabetes prospective follow-up registry was used to identify individuals with T1D or T2D ≥18 years starting CGM management in 2015 or later and follow-up information available. Hemoglobin A1c (HbA1c), BMI, and event rates of severe hypoglycemia in the year before CGM start were compared with two follow-up periods: (1) CGM use for 3-6 months and (2) CGM use for >6 months. Repeated measurements linear and negative binomial regressions were used (adjustment for sex, age at diabetes onset, and baseline parameters) and stratified by diabetes type. Mean follow-up time was 1.8 years in T1D ( = 2994) and 1.9 years in T2D ( = 1440). In T1D, adjusted mean HbA1c decreased significantly from 7.65% (95% confidence interval: 7.62-7.68) at baseline to 7.54% (7.51-7.57) during follow-up. BMI increased slightly (baseline: 25.4 kg/m [25.3-25.5], follow-up >6 months: 25.8 kg/m [25.7-25.9]), whereas event rates of severe hypoglycemia were significantly lower after >6 months with CGM (9.0 events/100 patient-years [PY; 8.0-10.1]) compared with baseline (11.3 events/100 PY [10.4-12.2]) in adults with T1D. In T2D, HbA1c decreased from 7.21% (7.17%-7.25%) to 7.00% (6.95%-7.04%) and BMI did not change after CGM initiation. Our results provide real-world evidence on CGM management in adult individuals with T1D or T2D. We suggest strengthening patients' and physicians' readiness toward diabetes technology in T2D and more openness of health insurance to cover cost based on proven benefits.
连续血糖监测（CGM）可能对 1 型（T1D）或 2 型糖尿病（T2D）成人的血糖控制和体重指数（BMI）产生有益影响。该研究使用糖尿病前瞻性随访登记来确定 2015 年或之后开始 CGM 管理且随访信息可用的 T1D 或 T2D≥18 岁的个体。在开始 CGM 前的一年中，血红蛋白 A1c（HbA1c）、BMI 和严重低血糖事件发生率与两个随访期进行了比较：（1）CGM 使用 3-6 个月；（2）CGM 使用>6 个月。采用重复测量线性和负二项式回归（性别、糖尿病发病年龄和基线参数的调整），并按糖尿病类型分层。T1D 的平均随访时间为 1.8 年（n=2994），T2D 为 1.9 年（n=1440）。在 T1D 中，调整后的平均 HbA1c 从基线时的 7.65%（95%置信区间：7.62-7.68）显著下降至随访期间的 7.54%（7.51-7.57）。BMI 略有增加（基线：25.4kg/m[25.3-25.5]，随访>6 个月：25.8kg/m[25.7-25.9]），而 T1D 患者在 CGM 开始>6 个月后严重低血糖事件的发生率明显降低（9.0 例/100 患者年[PY]；8.0-10.1]），而基线时为 11.3 例/100 PY（10.4-12.2）。在 T2D 中，HbA1c 从 7.21%（7.17%-7.25%）降至 7.00%（6.95%-7.04%），而 CGM 起始后 BMI 没有变化。我们的结果提供了 T1D 或 T2D 成人 CGM 管理的真实世界证据。我们建议在 T2D 中增强患者和医生对糖尿病技术的准备，并根据已证实的益处更开放地获得医疗保险覆盖费用。
