在大型儿科临床人群中，增加技术的使用与较低的 A1C 相关。
Increased Technology Use Associated With Lower A1C in a Large Pediatric Clinical Population.
机构信息
Barbara Davis Center, University of Colorado Anschutz Medical Campus, Aurora, CO.
School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO.
出版信息
Diabetes Care. 2023 Jun 1;46(6):1218-1222. doi: 10.2337/dc22-2121.
OBJECTIVE
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.
RESEARCH DESIGN AND METHODS
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.
RESULTS
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).
CONCLUSIONS
Adoption of CGM and HCL was associated with decreased A1C, suggesting promotion of these technologies may yield glycemic benefits.
目的
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。
研究设计和方法
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。
结果
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）。
结论
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。
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