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间歇性短期使用实时连续血糖监测系统对非胰岛素治疗的2型糖尿病患者的疗效:一项随机对照试验。

Efficacy of intermittent short-term use of a real-time continuous glucose monitoring system in non-insulin-treated patients with type 2 diabetes: A randomized controlled trial.

作者信息

Moon Sun Joon, Kim Kyung-Soo, Lee Woo Je, Lee Mi Yeon, Vigersky Robert, Park Cheol-Young

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.

出版信息

Diabetes Obes Metab. 2023 Jan;25(1):110-120. doi: 10.1111/dom.14852. Epub 2022 Sep 23.

Abstract

AIM

To evaluate the efficacy of intermittent short-term use of a real-time continuous glucose monitoring (RT-CGM) system in non-insulin-treated patients with type 2 diabetes (T2D) uncontrolled with oral antidiabetic drugs (OADs).

MATERIALS AND METHODS

In this multicentre, randomized prospective study, 61 participants were randomly assigned to treatment group 1 (one session of RT-CGM), treatment group 2 (two sessions of RT-CGM with a 3-month interval between sessions) and a control group. All participants used blinded continuous glucose monitoring for up to 6 days with education before randomization, and RT-CGM was additionally applied for 1 week in the intervention groups. The primary outcome was change in HbA1c at 6 months.

RESULTS

Among 61 participants, 48 subjects completed the study (baseline HbA1c 8.2% ± 0.5%). At 3 months, a significant HbA1c reduction was observed in treatment group 1 (adjusted difference = -0.60%, P = .044) and treatment group 2 (adjusted difference = -0.64%, P = .014) compared with the control group. However, at 6 months, only treatment group 2 achieved a significant HbA1c reduction (adjusted difference = -0.68%, P = .018). Especially in the treatment groups, patients performing self-monitoring of blood glucose (SMBG) at least 1.5 times/day showed a significant HbA1c improvement, at both 3 and 6 months, but those performing SMBG less than 1.5 times/day showed no significant improvement.

CONCLUSIONS

In non-insulin-treated patients with T2D uncontrolled with OADs, intermittent short-term use of RT-CGM was an effective method for glucose control, especially in those performing SMBG frequently.

摘要

目的

评估间歇性短期使用实时连续血糖监测(RT-CGM)系统对口服降糖药(OADs)治疗效果不佳的非胰岛素治疗2型糖尿病(T2D)患者的疗效。

材料与方法

在这项多中心、随机前瞻性研究中,61名参与者被随机分配到治疗组1(一次RT-CGM监测)、治疗组2(两次RT-CGM监测,两次监测间隔3个月)和一个对照组。所有参与者在随机分组前接受长达6天的盲法连续血糖监测并接受相关教育,干预组额外进行1周的RT-CGM监测。主要结局指标是6个月时糖化血红蛋白(HbA1c)的变化。

结果

61名参与者中,48名完成了研究(基线HbA1c为8.2%±0.5%)。在3个月时,与对照组相比,治疗组1(调整差异=-0.60%,P=0.044)和治疗组2(调整差异=-0.64%,P=0.014)的HbA1c显著降低。然而,在6个月时,只有治疗组2的HbA1c显著降低(调整差异=-0.68%,P=0.018)。特别是在治疗组中,每天至少进行1.5次自我血糖监测(SMBG)的患者在3个月和6个月时HbA1c均有显著改善,但每天进行SMBG少于1.5次的患者则无显著改善。

结论

在口服降糖药治疗效果不佳的非胰岛素治疗2型糖尿病患者中,间歇性短期使用RT-CGM是控制血糖的有效方法,尤其是对于频繁进行自我血糖监测的患者。

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