Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Miller School of Medicine, University of Miami, Miami, FL, USA.
J Diabetes Sci Technol. 2024 Jul;18(4):835-846. doi: 10.1177/19322968241242487. Epub 2024 Apr 17.
Continuous glucose monitoring (CGM) has transformed the care of type 1 and type 2 diabetes, and there is potential for CGM to also become influential in prediabetes identification and management. However, to date, we do not have any consensus guidelines or high-quality evidence to guide CGM goals and metrics for use in prediabetes.
We searched PubMed for all English-language articles on CGM use in nonpregnant adults with prediabetes published by November 1, 2023. We excluded any articles that included subjects with type 1 diabetes or who were known to be at risk for type 1 diabetes due to positive islet autoantibodies.
Based on the limited data available, we suggest possible CGM metrics to be used for individuals with prediabetes. We also explore the role that glycemic variability (GV) plays in the transition from normoglycemia to prediabetes.
Glycemic variability indices beyond the standard deviation and coefficient of variation are emerging as prominent identifiers of early dysglycemia. One GV index in particular, the mean amplitude of glycemic excursion (MAGE), may play a key future role in CGM metrics for prediabetes and is highlighted in this review.
连续血糖监测（CGM）改变了 1 型和 2 型糖尿病的治疗方式，它在糖尿病前期的识别和管理中也具有潜在的影响力。然而，迄今为止，我们没有任何共识指南或高质量证据来指导 CGM 在糖尿病前期的目标和指标。
我们在 PubMed 上搜索了截至 2023 年 11 月 1 日发表的关于 CGM 在非妊娠糖尿病前期成人中应用的所有英文文章。我们排除了任何包括 1 型糖尿病患者或因胰岛自身抗体阳性而有 1 型糖尿病风险的患者的文章。
根据有限的数据，我们建议使用可能的 CGM 指标来评估糖尿病前期患者。我们还探讨了血糖变异性（GV）在从正常血糖到糖尿病前期的转变中所起的作用。
除标准差和变异系数外，血糖变异性指数正在成为早期糖代谢异常的重要指标。血糖变异性指数中的一个突出指标，即血糖波动幅度（MAGE），可能在糖尿病前期的 CGM 指标中发挥关键作用，这在本综述中得到了强调。
