Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO.
School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO.
Diabetes Care. 2023 Jun 1;46(6):1218-1222. doi: 10.2337/dc22-2121.
While continuous glucose monitors (CGMs), insulin pumps, and hybrid closed-loop (HCL) systems each improve glycemic control in type 1 diabetes, it is unclear how the use of these technologies impacts real-world pediatric care.
We found 1,455 patients aged <22 years, with type 1 diabetes duration >3 months, and who had data from a single center in between both 2016-2017 (n = 2,827) and 2020-2021 (n = 2,731). Patients were grouped by multiple daily injections or insulin pump, with or without an HCL system, and using a blood glucose monitor or CGM. Glycemic control was compared using linear mixed-effects models adjusting for age, diabetes duration, and race/ethnicity.
CGM use increased from 32.9 to 75.3%, and HCL use increased from 0.3 to 27.9%. Overall A1C decreased from 8.9 to 8.6% (P < 0.0001).
Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits.
连续血糖监测仪（CGM）、胰岛素泵和混合闭环（HCL）系统均可改善 1 型糖尿病患者的血糖控制，但这些技术的使用如何影响现实世界中的儿科护理尚不清楚。
我们发现了 1455 名年龄<22 岁、1 型糖尿病病程>3 个月且在 2016-2017 年（n=2827）和 2020-2021 年（n=2731）之间某一中心有数据的患者。患者根据多次每日注射或胰岛素泵、有无 HCL 系统以及使用血糖仪或 CGM 进行分组。使用线性混合效应模型，根据年龄、糖尿病病程和种族/民族调整，比较血糖控制情况。
CGM 使用从 32.9%增加到 75.3%，HCL 使用从 0.3%增加到 27.9%。总体 A1C 从 8.9%降至 8.6%（P<0.0001）。
CGM 和 HCL 的采用与 A1C 的降低相关，表明推广这些技术可能会带来血糖益处。
