Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
J Diabetes Sci Technol. 2024 Nov;18(6):1460-1471. doi: 10.1177/19322968231176533. Epub 2023 May 26.
Diabetes is prevalent, and it imposes a substantial public health burden globally and in the Asia-Pacific (APAC) region. The cornerstone for optimizing diabetes management and treatment outcomes is glucose monitoring, the techniques of which have evolved from self-monitoring of blood glucose (SMBG) to glycated hemoglobin (HbA1c), and to continuous glucose monitoring (CGM). Contextual differences with Western populations and limited regionally generated clinical evidence warrant regional standards of diabetes care, including glucose monitoring in APAC. Hence, the APAC Diabetes Care Advisory Board convened to gather insights into clinician-reported CGM utilization for optimized glucose monitoring and diabetes management in the region. We discuss the findings from a pre-meeting survey and an expert panel meeting regarding glucose monitoring patterns and influencing factors, patient profiles for CGM initiation and continuation, CGM benefits, and CGM optimization challenges and potential solutions in APAC. While CGM is becoming the new standard of care and a useful adjunct to HbA1c and SMBG globally, glucose monitoring type, timing, and frequency should be individualized according to local and patient-specific contexts. The results of this APAC survey guide methods for the formulation of future APAC-specific consensus guidelines for the application of CGM in people living with diabetes.
糖尿病患病率高,给全球和亚太地区(APAC)带来了巨大的公共卫生负担。优化糖尿病管理和治疗效果的基石是血糖监测,其技术已经从自我血糖监测(SMBG)发展到糖化血红蛋白(HbA1c),再到连续血糖监测(CGM)。与西方人群的背景差异以及有限的区域性临床证据,需要在亚太地区制定糖尿病护理的区域性标准,包括血糖监测。因此,亚太糖尿病护理顾问委员会召开会议,收集有关临床医生报告的 CGM 应用的见解,以优化该地区的血糖监测和糖尿病管理。我们讨论了会前调查和专家小组会议的调查结果,内容涉及血糖监测模式和影响因素、CGM 启动和持续的患者特征、CGM 获益,以及亚太地区 CGM 优化的挑战和潜在解决方案。虽然 CGM 在全球范围内已成为新的护理标准和 HbA1c 和 SMBG 的有用补充,但根据当地和患者的具体情况,血糖监测的类型、时间和频率应个体化。该亚太地区调查的结果指导了未来针对糖尿病患者应用 CGM 的亚太地区特定共识指南的制定方法。