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扫描频率与1型糖尿病成年患者的连续血糖监测衍生指标及影响因素的关联

Association of scan frequency with CGM-derived metrics and influential factors in adults with type 1 diabetes mellitus.

作者信息

Sakane Naoki, Hirota Yushi, Yamamoto Akane, Miura Junnosuke, Takaike Hiroko, Hoshina Sari, Toyoda Masao, Saito Nobumichi, Hosoda Kiminori, Matsubara Masaki, Tone Atsuhito, Kawashima Satoshi, Sawaki Hideaki, Matsuda Tomokazu, Domichi Masayuki, Suganuma Akiko, Sakane Seiko, Murata Takashi

机构信息

Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555 Japan.

Division of Diabetes and Endocrinology, The Department of Internal Medicine, Kobe University Graduate School of Medicine Hyogo, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, 650-0017 Japan.

出版信息

Diabetol Int. 2023 Sep 12;15(1):109-116. doi: 10.1007/s13340-023-00655-9. eCollection 2024 Jan.

Abstract

INTRODUCTION

This study aimed to investigate the association between scan frequency and intermittently scanned continuous glucose monitoring (isCGM) metrics and to clarify the factors affecting scan frequency in adults with type 1 diabetes mellitus (T1D).

METHODS

We enrolled adults with T1D who used FreeStyle® Libre. Scan and self-monitoring of blood glucose (SMBG) frequency and CGM metrics from the past 90-day glucose data were collected. The receiver operating characteristic curve was plotted to obtain the optimal cutoff values of scan frequency for the target values of time in range (TIR), time above range (TAR), and time below range (TBR).

RESULTS

The study was conducted on 211 adults with T1D (mean age, 50.9 ± 15.2 years; male, 40.8%; diabetes duration, 16.4 ± 11.9 years; duration of CGM use, 2.1 ± 1.0 years; and mean HbA1c, 7.6 ± 0.9%). The average scan frequency was 10.5 ± 3.3 scan/day. Scan frequency was positively correlated with TIR and negatively correlated with TAR, although it was not significantly correlated with TBR. Scan frequency was positively correlated with the hypoglycemia fear survey-behavior score, while it was negatively correlated with some glycemic variability metrics. Adult patients with T1D and good exercise habits had a higher scan frequency than those without exercise habits. The AUC for > 70% of the TIR was 0.653, with an optimal cutoff of 11 scan/day.

CONCLUSIONS

In real-world conditions, frequent scans were linked to improved CGM metrics, including increased TIR, reduced TAR, and some glycemic variability metrics. Exercise habits and hypoglycemia fear-related behavior might affect scan frequency. Our findings could help healthcare professionals use isCGM to support adults with T1D.Clinical Trial Registry No. UMIN000039376.

摘要

引言

本研究旨在调查扫描频率与间歇性扫描连续血糖监测(isCGM)指标之间的关联,并阐明影响1型糖尿病(T1D)成人患者扫描频率的因素。

方法

我们招募了使用FreeStyle® Libre的T1D成人患者。收集过去90天血糖数据中的扫描和自我血糖监测(SMBG)频率以及CGM指标。绘制受试者工作特征曲线,以获取血糖达标时间(TIR)、高于目标范围时间(TAR)和低于目标范围时间(TBR)的目标值的扫描频率最佳截断值。

结果

该研究共纳入211例T1D成人患者(平均年龄50.9±15.2岁;男性占40.8%;糖尿病病程16.4±11.9年;CGM使用时长2.1±1.0年;平均糖化血红蛋白7.6±0.9%)。平均扫描频率为10.5±3.3次/天。扫描频率与TIR呈正相关,与TAR呈负相关,尽管与TBR无显著相关性。扫描频率与低血糖恐惧调查行为评分呈正相关,而与一些血糖变异性指标呈负相关。有良好运动习惯的T1D成年患者的扫描频率高于无运动习惯的患者。TIR>70%时的曲线下面积(AUC)为0.653,最佳截断值为11次/天。

结论

在实际情况下,频繁扫描与改善CGM指标有关,包括增加TIR、降低TAR以及一些血糖变异性指标。运动习惯和与低血糖恐惧相关的行为可能会影响扫描频率。我们的研究结果有助于医护人员使用isCGM来支持T1D成人患者。临床试验注册号:UMIN000039376。

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