连续血糖监测指标在早期识别糖尿病前期中的应用：系统评价和荟萃分析的方案。

Continuous glucose monitoring metrics for earlier identification of pre-diabetes: protocol for a systematic review and meta-analysis.

机构信息

Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA

Institute of Emerging Health Professions (IEHP), College of Health Professions, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.

出版信息

BMJ Open. 2022 Aug 25;12(8):e061756. doi: 10.1136/bmjopen-2022-061756.

DOI:10.1136/bmjopen-2022-061756

PMID:36008066

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9422846/

Abstract

INTRODUCTION

Glycaemic variability and other metrics are not well characterised in subjects without diabetes. More comprehensive sampling as obtained with continuous glucose monitoring (CGM) may improve diagnostic accuracy of the transition from health to pre-diabetes. Our goal is to investigate the glycaemic system as it shifts from health to pre-disease in adult patients without diabetes using CGM metrics. New insights may offer therapeutic promise for reversing dysglycaemia more successfully with dietary, nutritional and lifestyle change before progression occurs to pre-diabetes and diabetes.

METHODS AND ANALYSIS

This systematic review will include comprehensive searches of the PubMed, Scopus, Cochrane Library and ClinicalTrials.gov databases, with restrictions set to studies published in the last 10 years in English and planned search date 10 March 2022. Reference lists of studies that meet eligibility criteria in the screening process will subsequently be screened for the potential inclusion of additional studies. We will include studies that examine CGM use and report diagnostic criteria such as fasting glucose and/or haemoglobin A1c such that we can assess correlation between CGM metrics and established diagnostic criteria and describe how CGM metrics are altered in the transition from health to pre-diabetes. The screening and data extraction will be conducted by two independent reviewers using Covidence. All included papers will also be evaluated for quality and publication bias using Cochrane Collaboration risk of bias tools. If there are two or more studies with quantitative estimates that can be combined, we will conduct a meta-analysis after assessing heterogeneity.

ETHICS AND DISSEMINATION

The systematic review methodology does not require formal ethical review due to the nature of the study design. Study findings will be publicly available and published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42022308222.

摘要

简介

在非糖尿病患者中，血糖变异性和其他指标的特征尚未得到很好的描述。通过连续血糖监测（CGM）进行更全面的采样，可能会提高从健康到糖尿病前期的过渡的诊断准确性。我们的目标是使用 CGM 指标研究成年人在没有糖尿病的情况下从健康到疾病前期的血糖系统变化。新的见解可能为通过饮食、营养和生活方式改变来成功逆转糖尿病前期和糖尿病发生前的血糖异常提供治疗前景。

方法和分析

本系统评价将全面检索 PubMed、Scopus、Cochrane 图书馆和 ClinicalTrials.gov 数据库，限制为过去 10 年以英语发表的研究，并计划于 2022 年 3 月 10 日进行搜索。随后将对符合筛选过程中纳入标准的研究的参考文献进行筛选，以确定是否有其他研究符合纳入标准。我们将纳入使用 CGM 并报告诊断标准（如空腹血糖和/或糖化血红蛋白）的研究，以便我们可以评估 CGM 指标与既定诊断标准之间的相关性，并描述 CGM 指标在从健康到糖尿病前期的转变中是如何改变的。筛选和数据提取将由两名独立的审查员使用 Covidence 进行。所有纳入的论文也将使用 Cochrane 协作风险偏倚工具进行质量和发表偏倚评估。如果有两项或更多具有可合并的定量估计的研究，我们将在评估异质性后进行荟萃分析。