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1型糖尿病儿童、青少年和青年中持续血糖监测与快速血糖监测的比较:一项为期8周的前瞻性随机试验

Comparison Between Continuous Versus Flash Glucose Monitoring in Children, Adolescents, and Young Adults with Type 1 Diabetes: An 8-Week Prospective Randomized Trial.

作者信息

Messaaoui Anissa, Tenoutasse Sylvie, Hajselova Lucia, Crenier Laurent

机构信息

Diabetology Clinic, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles (ULB), HUDERF, 15 Jean-Joseph Crocq avenue, 1020, Brussels, Belgium.

Department of Endocrinology, Hôpital Erasme, Université Libre de Bruxelles (ULB), 808 Lennik Route, 1070, Brussels, Belgium.

出版信息

Diabetes Ther. 2022 Sep;13(9):1671-1681. doi: 10.1007/s13300-022-01297-x. Epub 2022 Jul 23.

Abstract

INTRODUCTION

To assess the impact of real-time continuous glucose monitoring (RT-CGM) instead of first-generation flash glucose monitoring (FGM) on hypoglycaemia in children and adolescents with type 1 diabetes.

METHODS

In this randomized controlled interventional study, young individuals with type 1 diabetes used RT-CGM or FGM for 8 weeks. We evaluated changes in time below range (TBR), severe hypoglycaemia (SH), HbA1c, glycaemic variability, and impaired awareness of hypoglycaemia with RT-CGM (intervention group) in comparison with FGM.

RESULTS

We randomly assigned 37 participants to either the intervention group (n = 19) or the control group (n = 18). At 8 weeks, we did not find a decrease in TBR in either group, but there was a significant reduction in SH in the intervention group. For participants with TBR ≥ 5% at baseline, we observed significant reductions in 24-h TBR, wake TBR, sleep TBR, and glucose variability at 8 weeks in the intervention group.

CONCLUSIONS

The use of RT-CGM versus FGM decreased SH in young individuals with type 1 diabetes, and TBR and glucose variability in patients with a higher TBR at baseline. The patient's history should be taken into account when advising on the method of blood glucose monitoring, as RT-CGM could be more effective in younger patients at high risk for SH.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04249102.

摘要

引言

评估实时连续血糖监测(RT-CGM)而非第一代动态葡萄糖监测(FGM)对1型糖尿病儿童和青少年低血糖的影响。

方法

在这项随机对照干预研究中,1型糖尿病青少年使用RT-CGM或FGM达8周。我们评估了与FGM相比,RT-CGM(干预组)在血糖低于范围时间(TBR)、严重低血糖(SH)、糖化血红蛋白(HbA1c)、血糖变异性以及低血糖意识受损方面的变化。

结果

我们将37名参与者随机分为干预组(n = 19)或对照组(n = 18)。在8周时,我们发现两组的TBR均未降低,但干预组的SH显著降低。对于基线时TBR≥5%的参与者,我们观察到干预组在8周时24小时TBR、清醒时TBR、睡眠时TBR以及血糖变异性均显著降低。

结论

与FGM相比,RT-CGM的使用降低了1型糖尿病青少年的SH,以及基线时TBR较高患者的TBR和血糖变异性。在就血糖监测方法提供建议时应考虑患者病史,因为RT-CGM可能对SH高危的年轻患者更有效。

试验注册

ClinicalTrials.gov NCT04249102。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bde6/9399330/a835045a81de/13300_2022_1297_Fig1_HTML.jpg

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