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《无糖尿病患者使用连续血糖监测仪:时机已到?》

Use of Continuous Glucose Monitors by People Without Diabetes: An Idea Whose Time Has Come?

机构信息

Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA.

Diabetes Technology Society, Burlingame, CA, USA.

出版信息

J Diabetes Sci Technol. 2023 Nov;17(6):1686-1697. doi: 10.1177/19322968221110830. Epub 2022 Jul 20.


DOI:10.1177/19322968221110830
PMID:35856435
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10658694/
Abstract

BACKGROUND: Continuous glucose monitor (CGM) systems were originally intended only for people with diabetes. Recently, there has been interest in monitoring glucose concentrations in a variety of other situations. As data accumulate to support the use of CGM systems in additional states unrelated to diabetes, the use of CGM systems is likely to increase accordingly. METHODS: PubMed and Google Scholar were searched for articles about the use of CGM in individuals without diabetes. Relevant articles that included sufficient details were queried to identify what cohorts of individuals were adopting CGM use and to define trends of use. RESULTS: Four clinical user cases were identified: (1) metabolic diseases related to diabetes with a primary dysregulation of the insulin-glucose axis, (2) metabolic diseases without a primary pathophysiologic derangement of the insulin-glucose axis, (3) health and wellness, and (4) elite athletics. Seven trends in the use of CGM systems in people without diabetes were idenfitied which pertained to both FDA-cleared medical grade products as well as anticipated future products, which may be regulated differently based on intended populations and indications for use. CONCLUSIONS: Wearing a CGM has been used not only for diabetes, but with a goal of improving glucose patterns to avoid diabetes, improving mental or physical performance, and promoting motivate healthy behavioral changes. We expect that clinicians will become increasingly aware of (1) glycemic patterns from CGM tracings that predict an increased risk of diabetes, (2) specific metabolic glucotypes from CGM tracings that predict an increased risk of diabetes, and (3) new genetic and genomic biomarkers in the future.

摘要

背景:连续血糖监测(CGM)系统最初仅用于糖尿病患者。最近,人们对监测各种与糖尿病无关的情况下的血糖浓度产生了兴趣。随着支持 CGM 系统在与糖尿病无关的其他状态下使用的数据不断积累,CGM 系统的使用预计将相应增加。

方法:在 PubMed 和 Google Scholar 上搜索关于非糖尿病患者使用 CGM 的文章。查询了包含足够详细信息的相关文章,以确定哪些人群正在采用 CGM 并定义使用趋势。

结果:确定了四个临床用户案例:(1)与糖尿病相关的代谢疾病,其胰岛素-葡萄糖轴的主要调节失常,(2)代谢疾病,其胰岛素-葡萄糖轴没有原发性病理生理紊乱,(3)健康和保健,以及(4)精英运动。在非糖尿病患者中使用 CGM 系统的七种趋势被确定,这些趋势既涉及到已获得 FDA 批准的医疗级产品,也涉及到预期的未来产品,这些产品可能根据预期人群和使用适应症而受到不同的监管。

结论:佩戴 CGM 不仅用于糖尿病,还用于改善血糖模式以避免糖尿病、改善心理或身体表现以及促进健康行为的改变。我们预计,临床医生将越来越意识到(1)CGM 追踪预测糖尿病风险增加的血糖模式,(2)CGM 追踪预测糖尿病风险增加的特定代谢性血糖类型,以及(3)未来新的遗传和基因组生物标志物。

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本文引用的文献

[1]
Use of a Continuous Glucose Monitor to Determine the Glycaemic Index of Rice-Based Mixed Meals, Their Effect on a 24 h Glucose Profile and Its Influence on Overweight and Obese Young Adults' Meal Preferences.

Foods. 2022-3-28

[2]
Risks and burdens of incident diabetes in long COVID: a cohort study.

Lancet Diabetes Endocrinol. 2022-5

[3]
Continuous Glucose Monitoring in Healthy Adults-Possible Applications in Health Care, Wellness, and Sports.

Sensors (Basel). 2022-3-5

[4]
Concurrent Validity of a Continuous Glucose-Monitoring System at Rest and During and Following a High-Intensity Interval Training Session.

Int J Sports Physiol Perform. 2022-4-1

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Annu Rev Med. 2022-1-27

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Diabetes Care. 2022-1-1

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Performance of intermittently scanned continuous glucose monitoring systems in people with type 1 diabetes: A pooled analysis.

Diabetes Obes Metab. 2022-3

[8]
Continuous Glucose Monitoring and HbA1c in Cystic Fibrosis: Clinical Correlations and Implications for CFRD Diagnosis.

J Clin Endocrinol Metab. 2022-3-24

[9]
Obesity and Diabetes.

Nurs Clin North Am. 2021-12

[10]
Spontaneous and iatrogenic hypoglycemia in cystic fibrosis.

J Clin Transl Endocrinol. 2021-10-13

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