1型糖尿病成年患者使用实时连续葡萄糖监测的有效性预测因素：ISCHIA研究的事后分析
Predictors of the effectiveness of isCGM usage in adults with type 1 diabetes mellitus: post-hoc analysis of the ISCHIA study.
作者信息
Murata Takashi, Hirota Yushi, Hosoda Kiminori, Kato Ken, Kouyama Kunichi, Kouyama Ryuji, Kuroda Akio, Matoba Yuka, Matsuhisa Munehide, Meguro Shu, Miura Junnosuke, Nishimura Kunihiro, Sakane Naoki, Shimada Akira, Suzuki Shota, Tone Atsuhito, Toyoda Masao
机构信息
Department of Clinical Nutrition, NHO Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555 Japan.
Diabetes Center, NHO Kyoto Medical Center, Kyoto, Japan.
出版信息
Diabetol Int. 2024 Feb 15;15(3):400-405. doi: 10.1007/s13340-023-00683-5. eCollection 2024 Jul.
AIM
The Effect of Intermittent-Scanning Continuous Glucose Monitoring to Glycemic Control Including Hypoglycemia and Quality of Life of Patients with Type 1 Diabetes Mellitus (ISCHIA) study was a randomized, crossover trial that reported the decrease in time below range (TBR) by the use of intermittent-scanning continuous glucose monitoring (isCGM) combined with structured education in adults with type 1 diabetes (T1D) treated by multiple daily injections. The participants were instructed to perform frequent scanning of the isCGM sensor (10 times a day or more) and ingest sugar when impending hypoglycemia is suspected by tracking the sensor glucose levels and the trend arrow. We conducted post-hoc analysis to identify factors affecting difference in TBR (∆TBR), in time in range (∆TIR), and in time above range (∆TAR).
PARTICIPANTS AND METHODS
Data from 93 participants who completed the ISCHIA study were used. Multiple regression analyses were performed to identify factors affecting CGM metrics.
RESULTS
Pearson's correlation analysis showed the negative association between log-transformed scan frequency and with ∆TBR ( = - 0.255, = 0.015), while there was no significant association of log-transformed scan frequency with ∆TIR ( = 0.172, = 0.102) and ∆TAR ( = 0.032, = 0.761), respectively. The log-transformed scan frequency was an independent predictor of ∆TBR (Beta = - 7.712, = 0.022), but not of ∆TIR(Beta = 7.203, = 0.091) and of ∆TAR (Beta = 0.514, = 0.925).
CONCLUSIONS
Our findings suggest that more frequent scanning of isCGM may be beneficial to reduce TBR in T1D adults.
目的
间歇性扫描式连续血糖监测对1型糖尿病患者血糖控制（包括低血糖）及生活质量的影响（ISCHIA）研究是一项随机交叉试验，该试验报告了在接受多次每日注射治疗的1型糖尿病（T1D）成人患者中，使用间歇性扫描式连续血糖监测（isCGM）并结合结构化教育后，低于目标范围时间（TBR）的减少情况。参与者被指导频繁扫描isCGM传感器（每天10次或更多），并通过跟踪传感器葡萄糖水平和趋势箭头，在怀疑即将发生低血糖时摄入糖分。我们进行了事后分析，以确定影响TBR差异（∆TBR）、血糖在目标范围内时间差异（∆TIR）和高于目标范围时间差异（∆TAR）的因素。
参与者和方法
使用了来自93名完成ISCHIA研究的参与者的数据。进行多元回归分析以确定影响连续血糖监测指标的因素。
结果
Pearson相关性分析显示，对数转换后的扫描频率与∆TBR呈负相关（r = - 0.255，P = 0.015），而对数转换后的扫描频率与∆TIR（r = 0.172，P = 0.102）和∆TAR（r = 0.032，P = 0.761）之间分别无显著相关性。对数转换后的扫描频率是∆TBR的独立预测因素（β = - 7.712，P = 0.022），但不是∆TIR（β = 7.203，P = 0.091）和∆TAR（β = 0.514，P = 0.925）的独立预测因素。
结论
我们的研究结果表明，更频繁地扫描isCGM可能有助于降低T1D成人患者的TBR。
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