Chief Diabetologist & Chairman, Diabetes Care & Hormone Clinic, Ahmedabad, Gujarat.
Vice Chairman & Consultant Diabetologist; Department of Diabetology, Dr Mohan's Diabetes Specialities Centre & Madras Diabetes Research Foundation, Chennai, Tamil Nadu.
J Assoc Physicians India. 2023 Jun;71(6):11-12. doi: 10.5005/japi-11001-0274.
To suggest how continuous glucose monitoring (CGM) may be used intermittently in individuals with type 2 diabetes (T2D).
The use of CGM is largely in those with type 1 diabetes (T1D), in whom it makes sense to use CGM continuously as CGM provides a valuable tool to not only adjust their insulin doses but also to match it with their diet, physical activity, and other lifestyle modifications. In the case of T2D, however, especially for those not on insulin, the use of CGM may not be needed on a continuous basis. The use of CGM on an intermittent basis is rarely discussed in the literature. This article tries to provide clinical situations where CGM can be used intermittently.
Intermittent use of CGM defined as the "use of CGM once in 2 or 3 months or a fixed frequency," and may be useful in several situations in those with T2D. We suggest the following indications for the intermittent use of CGM in T2D-newly diagnosed patients where treatment is being started, uncontrolled diabetes where treatment is being altered, starting intensive lifestyle modification, during infections, during preoperative control, in children and adolescents with T2D, as a motivational tool to improve behavioral modification, after metabolic surgery, and in patients on steroids, apart from other indications.
Intermittent use of CGM in T2D can be useful in special situations and can also be cost saving particularly in resource-constrained regions of the world.
探讨如何在 2 型糖尿病(T2D)患者中间歇性使用连续血糖监测(CGM)。
CGM 的应用主要针对 1 型糖尿病(T1D)患者,在这些患者中,连续使用 CGM 是有意义的,因为 CGM 不仅提供了调整胰岛素剂量的有价值工具,还可以与饮食、体育活动和其他生活方式改变相匹配。然而,对于 T2D 患者,特别是那些未使用胰岛素的患者,可能不需要连续使用 CGM。CGM 的间歇性使用在文献中很少讨论。本文试图提供 CGM 可间歇性使用的临床情况。
CGM 的间歇性使用定义为“每 2 或 3 个月使用一次 CGM 或固定频率”,在 T2D 患者的几种情况下可能有用。我们建议将 CGM 的间歇性使用用于以下 T2D 患者的适应证:新诊断开始治疗的患者、正在改变治疗方案的未控制糖尿病患者、开始强化生活方式改变的患者、感染期间、术前控制期间、T2D 儿童和青少年患者、作为改善行为改变的激励工具、代谢手术后以及使用类固醇的患者,此外还有其他适应证。
在特殊情况下,T2D 患者的 CGM 间歇性使用可能有用,尤其是在世界资源有限的地区还可以节省成本。