Department of Internal Medicine, Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Tikkamäentie 16, 80210, Joensuu, Finland.
Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
Acta Diabetol. 2023 Jul;60(7):891-898. doi: 10.1007/s00592-023-02079-y. Epub 2023 Mar 28.
To determine the effect of the use of intermittently scanned continuous glucose monitoring (isCGM) on acute diabetes-related complications in adult type 1 diabetes patients.
Six hundred and forty-two adult type 1 diabetes patients with isCGM were identified from electronic health records in Siun sote region in Eastern Finland. A retrospective real-world analysis was conducted combining hospital admission and prehospital emergency service data to compare incidences of hypoglycemia requiring emergency medical support (EMS) involvement or hospital admission and diabetic ketoacidosis (DKA) before and after the start of isCGM. Data were collected from January 2015 to April 2020. Primary outcome was the rate of hypoglycemia requiring EMS involvement or hospital admission and DKA events. HbA1c was recorded at the start of isCGM and was compared with the last known HbA1c during the use of isCGM. The isCGM used in the study did not contain alarm functions.
Altogether 220 hypoglycemic events were identified during the study period. Incidence rate of hypoglycemic events decreased after the start of isCGM (72 events, incidence rate 50 events/1000 person-years) compared with the time before the start (148 events, incidence rate 76 events/1000 person-years) (p = 0.043). The incidence rate of DKA decreased after the start of isCGM compared with time before isCGM use (4 and 15 events/1000 person-years, respectively; p = 0.002). The change in mean HbA1c was - 0.28% (- 3.1 mmol/mol) between baseline and the last HbA1c measurement (p < 0.001).
In addition to lowering HbA1c in type 1 diabetes patients, isCGM is also effective in preventing acute diabetes-related complications such as hypoglycemia requiring EMS involvement or hospital admission and DKA.
确定间歇性扫描连续血糖监测（isCGM）在成年 1 型糖尿病患者急性糖尿病相关并发症中的作用。
从芬兰东部 Siun sote 地区的电子健康记录中确定了 642 名使用 isCGM 的成年 1 型糖尿病患者。结合医院入院和院前急救服务数据进行回顾性真实世界分析，比较 isCGM 开始前后低血糖需要紧急医疗支持（EMS）介入或入院和糖尿病酮症酸中毒（DKA）的发生率。数据收集时间为 2015 年 1 月至 2020 年 4 月。主要结局是需要 EMS 介入或入院和 DKA 事件的低血糖发生率。在开始使用 isCGM 时记录 HbA1c，并与使用 isCGM 期间的最后一次已知 HbA1c 进行比较。该研究中使用的 isCGM 不包含报警功能。
在研究期间共发现 220 例低血糖事件。与开始 isCGM 前相比（72 例，发生率 50 例/1000 人年），开始 isCGM 后低血糖事件的发生率降低（148 例，发生率 76 例/1000 人年）（p=0.043）。与使用 isCGM 前相比，使用 isCGM 后 DKA 的发生率降低（4 例和 15 例/1000 人年，分别；p=0.002）。与基线相比，最后一次 HbA1c 测量的平均 HbA1c 变化为-0.28%（-3.1mmol/mol）（p<0.001）。
除了降低 1 型糖尿病患者的 HbA1c 外，isCGM 还能有效预防急性糖尿病相关并发症，如低血糖需要 EMS 介入或入院和 DKA。
