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比较两种连续血糖监测仪的临床结局:1型和2型糖尿病患者中糖尿病相关事件、全因住院率及糖化血红蛋白降低情况相似

Comparing clinical outcomes between two continuous glucose monitors: similar diabetes-related events, all-cause hospitalizations and HbA1c reductions in type 1 and type 2 diabetes.

作者信息

Miller Eden, Roberts Gregory J, Joseph Jennifer M, Nabutovsky Yelena, Reyes Ignacio J, Souto Diana, Virdi Naunihal, Hirsch Irl B

机构信息

Diabetes and Obesity Care, Bend, OR, USA.

Abbott, Sylmar, CA, USA.

出版信息

Am J Med Open. 2022 Feb 10;9:100008. doi: 10.1016/j.ajmo.2022.100008. eCollection 2023 Jun.

Abstract

OBJECTIVES

We compared clinical outcomes after acquiring a FreeStyle Libre© Flash Continuous Glucose Monitoring System (FSL) or Dexcom (DEX) continuous glucose monitoring (CGM) device in individuals with type 1 diabetes (T1D) and type 2 diabetes (T2D) treated with intensive insulin therapy.

DESIGN AND METHODS

This retrospective analysis of the IBM® MarketScan® Research Databases and IBM® Explorys® Electronic Health Records Database assessed differences in acute diabetes-related events (ADE), all-cause hospitalizations (ACH) and glycated hemoglobin (HbA1c) in T1D and T2D populations 6 months post CGM acquisition. Analyses were conducted in two study cohorts (Cohort 1,  = 7,494; Cohort 2,  = 678). Participants were T1D or T2D, age ≥ 18 years, treated with short or rapid-acting insulin and naïve to CGM, who acquired a CGM system. Users were propensity score matched on demographics and clinical factors.

RESULTS

Cohort 1: Post-CGM ADE-free rates at 6 months ranged from 94.8 to 96.7% and ACH-free rates ranged from 90.4 to 95.4%, for both T1D and T2D groups, with no significant differences between CGM systems. Cohort 2: Significant HbA1c reductions were associated with use of the DEX and FSL devices in the T1D (-0.35% and -0.37%, respectively) and T2D (-0.73% and -0.79%, respectively) cohorts, both  < 0.001, with no significant differences in the magnitude of reduction between systems (T1D  = 0.99 and T2D  = 0.84).

CONCLUSIONS

Acquisition of the FSL and DEX systems was associated with similar rates of acute diabetes-related events and all-cause hospitalizations and similar HbA1c reductions in adults with T1D and T2D.

摘要

目的

我们比较了1型糖尿病(T1D)和2型糖尿病(T2D)患者在接受强化胰岛素治疗后,使用FreeStyle Libre© 闪光连续血糖监测系统(FSL)或德康(DEX)连续血糖监测(CGM)设备后的临床结局。

设计与方法

这项对IBM® MarketScan® 研究数据库和IBM® Explorys® 电子健康记录数据库的回顾性分析,评估了T1D和T2D人群在获取CGM设备6个月后急性糖尿病相关事件(ADE)、全因住院(ACH)和糖化血红蛋白(HbA1c)的差异。分析在两个研究队列中进行(队列1,n = 7494;队列2,n = 678)。参与者为年龄≥18岁、接受短效或速效胰岛素治疗且初次使用CGM的T1D或T2D患者,他们获取了CGM系统。使用者根据人口统计学和临床因素进行倾向得分匹配。

结果

队列1:T1D和T2D组在CGM使用6个月后的无ADE率范围为94.8%至96.7%,无ACH率范围为90.4%至95.4%,两种CGM系统之间无显著差异。队列2:在T1D(分别为-0.35%和-0.37%)和T2D(分别为-0.73%和-0.79%)队列中,使用DEX和FSL设备与HbA1c显著降低相关,均P < 0.001,系统间降低幅度无显著差异(T1D中P = 0.99,T2D中P = 0.84)。

结论

获取FSL和DEX系统与T1D和T2D成人患者中相似的急性糖尿病相关事件发生率、全因住院率以及相似的HbA1c降低相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/40e9/11256287/d195e68453b1/gr1.jpg

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