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在有发生急性糖尿病并发症风险的 1 型糖尿病患者中,动态血糖监测系统在预防严重低血糖发作以及改善血糖指标和生活质量方面的有效性。

Effectiveness of the flash glucose monitoring system in preventing severe hypoglycemic episodes and in improving glucose metrics and quality of life in subjects with type 1 diabetes at high risk of acute diabetes complications.

机构信息

Department of Medicine and Surgery, Division of Nutritional and Metabolic Sciences, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126, Parma, Italy.

Department of Medicine and Surgery, Università di Parma, Parma, Italy.

出版信息

Acta Diabetol. 2024 Sep;61(9):1177-1184. doi: 10.1007/s00592-024-02298-x. Epub 2024 Jun 4.

DOI:10.1007/s00592-024-02298-x
PMID:38833007
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11379770/
Abstract

AIMS

To assess the effectiveness of the intermittent-scanned continuous glucose monitoring (isCGM) system in preventing severe hypoglycemic episodes and in improving glucose parameters and quality of life.

METHODS

Four hundred T1D individuals were enrolled in a prospective real-word study with an intermittently scanned continuous glucose monitoring device during the 12-months follow-up. The primary endpoint was the incidence of severe hypoglycemic events.

RESULTS

82% of subjects were naïve to the use of the device (group A) and 18% were already wearing the system (group B). The cumulative incidence of severe hypoglycemia (SH) at 12 months was 12.06 per 100 person-year (95% CI: 8.35-16.85) in group A and 10.14 (95% CI: 4.08-20.90) in group B without inter-group differences. In group A there was a significant decrease in SH at 12 months compared to 3 months period (p = 0.005). Time in glucose range significantly increased in both groups accompanied with a significant decrease in glucose variability. HbA1c showed a progressive significant time-dependent decrease in group A. The use of the device significantly improved the perceived quality of life.

CONCLUSION

This study confirmed the effectiveness of the isCGM in reducing hypoglycemic risk without glucose deterioration, with potential benefits on adverse outcomes in T1D individuals.

TRIAL REGISTRATION

ClinicalTrials.gov registration no. NCT04060732.

摘要

目的

评估间歇性扫描连续血糖监测(isCGM)系统在预防严重低血糖事件以及改善血糖参数和生活质量方面的有效性。

方法

在 12 个月的随访中,400 例 1 型糖尿病患者使用间歇性扫描连续血糖监测设备进行了前瞻性真实世界研究。主要终点是严重低血糖事件的发生率。

结果

82%的受试者首次使用该设备(A 组),18%的受试者已经佩戴该系统(B 组)。A 组 12 个月的严重低血糖(SH)累积发生率为 12.06/100 人年(95%CI:8.35-16.85),B 组为 10.14/100 人年(95%CI:4.08-20.90),两组间无差异。与 3 个月相比,A 组 12 个月的 SH 显著减少(p=0.005)。两组的血糖范围时间均显著增加,血糖变异性显著降低。A 组的 HbA1c 呈进行性显著时间依赖性下降。使用该设备显著改善了感知生活质量。

结论

本研究证实了 isCGM 在不恶化血糖的情况下降低低血糖风险的有效性,对 1 型糖尿病患者的不良结局可能具有潜在益处。

临床试验注册

ClinicalTrials.gov 注册号 NCT04060732。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/4a8e75f33902/592_2024_2298_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/d41473ebea9b/592_2024_2298_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/f05687b72871/592_2024_2298_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/0c2bc28ad561/592_2024_2298_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/4a8e75f33902/592_2024_2298_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/d41473ebea9b/592_2024_2298_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/f05687b72871/592_2024_2298_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/0c2bc28ad561/592_2024_2298_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd9c/11379770/4a8e75f33902/592_2024_2298_Fig4_HTML.jpg

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Efficacy of a training programme for the management of diabetes mellitus in the hospital: A randomized study (stage 2 of GOVEPAZ healthcare).医院糖尿病管理培训计划的效果:一项随机研究(GOVEPAZ 医疗保健项目的第 2 阶段)
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