Eviz Elif, Yesiltepe Mutlu Gul, Karakus Kagan Ege, Can Ecem, Gokce Tugba, Muradoglu Serra, Hatun Sukru
Division of Pediatric Endocrinology and Diabetes, Koc University School of Medicine, Istanbul, Turkey.
Division of Pediatric Endocrinology and Diabetes, Koc University Hospital, Istanbul, Turkey.
Diabetes Technol Ther. 2023 Oct;25(10):689-696. doi: 10.1089/dia.2023.0112. Epub 2023 Sep 1.
The Glycemia Risk Index (GRI) and Continuous Glucose Monitoring Index (COGI) are newly defined composite metric parameters derived from continuous glucose monitoring (CGM) data. GRI is divided into five separate risk zones (from lowest to highest: A-E). In this study, the effect of the advanced hybrid closed loop (AHCL) system on GRI and COGI in children with type 1 diabetes was evaluated. Forty-five children who had started using the AHCL and whose baseline and sixth-month CGM data were available were analyzed in terms of achievement of CGM consensus goals and changes in GRI scores and zones. The paired -test was used for the analyses. The mean age and duration of diabetes of the participants were 10.95 ± 3.41 and 3.85 ± 2.67 years, respectively. The mean GRI score significantly decreased from 35.66 ± 17.46 at baseline to 22.83 ± 9.08 at 6 months ( < 0.001). Although the proportion of those in the A zone was 20% at baseline, it increased to 42% at 6 months. AHCL also improved COGI from 72.59 ± 12.44 to 82.90 ± 7.72 ( < 0.001). Time in range (TIR) increased significantly from 70.54% to 80.51% ( < 0.001) at 6 months. AHCL provides not only an improvement in TIR but also a significant improvement in both GRI and COGI at 6 months. The incorporation of GRI and COGI alongside TIR may enhance the assessment of the glycemic profile by providing a more comprehensive and in-depth analysis.
血糖风险指数（GRI）和连续血糖监测指数（COGI）是从连续血糖监测（CGM）数据中得出的新定义的综合指标参数。GRI分为五个不同的风险区域（从最低到最高：A - E）。在本研究中，评估了先进混合闭环（AHCL）系统对1型糖尿病儿童GRI和COGI的影响。对45名开始使用AHCL且有基线和六个月CGM数据的儿童，就CGM共识目标的达成情况以及GRI分数和区域的变化进行了分析。分析采用配对检验。参与者的平均年龄和糖尿病病程分别为10.95±3.41岁和3.85±2.67年。平均GRI分数从基线时的35.66±17.46显著降至6个月时的22.83±9.08（<0.001）。尽管A区的比例在基线时为20%，但在6个月时增至42%。AHCL还将COGI从72.59±12.44改善至82.90±7.72（<0.001）。6个月时，血糖达标时间（TIR）从70.54%显著增至80.51%（<0.001）。AHCL不仅改善了TIR，还在6个月时使GRI和COGI都有显著改善。将GRI和COGI与TIR结合使用，可能通过提供更全面、深入的分析来增强对血糖状况的评估。
