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西班牙临床实践中连续血糖监测及其血糖指标的影响和未来展望:叙述性综述。

Impact of Continuous Glucose Monitoring and its Glucometrics in Clinical Practice in Spain and Future Perspectives: A Narrative Review.

机构信息

Endocrinology and Nutrition Unit, Segovia General Hospital, Segovia, Spain.

Pediatric Endocrinology Service, Hospital Regional de Málaga, Málaga, Spain.

出版信息

Adv Ther. 2024 Sep;41(9):3471-3488. doi: 10.1007/s12325-024-02943-5. Epub 2024 Aug 2.

Abstract

INTRODUCTION

Continuous glucose monitoring (CGM) devices allow for 24-h real-time measurement of interstitial glucose levels and have changed the interaction between people with diabetes and their health care providers. The large amount of data generated by CGM can be analyzed and evaluated using a set of standardized parameters, collectively named glucometrics. This review aims to provide a summary of the existing evidence on the use of glucometrics data and its impact on clinical practice based on published studies involving adults and children with type 1 diabetes (T1D) in Spain.

METHODS

The PubMed and MEDES (Spanish Medical literature) databases were searched covering the years 2018-2022 and including clinical and observational studies, consensus guidelines, and meta-analyses on CGM and glucometrics conducted in Spain.

RESULTS

A total of 16 observational studies were found on the use of CGM in Spain, which have shown that cases of severe hypoglycemia in children with T1D were greatly reduced after the introduction of CGM, resulting in a significant reduction in costs. Real-world data from Spain shows that CGM is associated with improved glycemic markers (increased time in range, reduced time below and above range, and glycemic variability), and that there is a relationship between glycemic variability and hypoglycemia. Also, CGM and analysis of glucometrics proved highly useful during the COVID-19 pandemic. New glucometrics, such as the glycemic risk index, or new mathematical approaches to the analysis of CGM-derived glucose data, such as "glucodensities," could help patients to achieve better glycemic control in the future.

CONCLUSION

By using glucometrics in clinical practice, clinicians can better assess glycemic control and a patient's individual response to treatment.

摘要

简介

连续血糖监测(CGM)设备可实现 24 小时实时测量间质血糖水平,并改变了糖尿病患者及其医疗保健提供者之间的互动方式。CGM 产生的大量数据可以使用一组标准化参数进行分析和评估,这些参数统称为血糖计量学。本综述旨在根据涉及西班牙 1 型糖尿病(T1D)成人和儿童的已发表研究,提供关于血糖计量学数据的使用及其对临床实践的影响的现有证据总结。

方法

检索了 PubMed 和 MEDES(西班牙医学文献)数据库,涵盖了 2018-2022 年的研究,并包括了在西班牙进行的关于 CGM 和血糖计量学的临床和观察性研究、共识指南和荟萃分析。

结果

共发现了 16 项关于 CGM 在西班牙使用的观察性研究,这些研究表明,T1D 儿童在引入 CGM 后严重低血糖的病例大大减少,从而显著降低了成本。来自西班牙的真实数据表明,CGM 与改善血糖标志物(增加达标时间、减少低于和高于目标范围的时间以及血糖变异性)相关,且血糖变异性与低血糖之间存在关联。此外,CGM 和血糖计量学分析在 COVID-19 大流行期间也非常有用。新的血糖计量学,如血糖风险指数,或分析 CGM 衍生葡萄糖数据的新数学方法,如“葡萄糖密度”,未来可能有助于患者实现更好的血糖控制。

结论

通过在临床实践中使用血糖计量学,临床医生可以更好地评估血糖控制和患者对治疗的个体反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b03/11349838/656c3c59026c/12325_2024_2943_Fig1_HTML.jpg

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