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在英国,多次每日注射胰岛素治疗的2型糖尿病患者中,动态血糖监测与糖化血红蛋白改善相关:一项回顾性观察研究。

Flash Glucose Monitoring is Associated with HbA1c Improvement in Type 2 Diabetes Managed with Multiple Daily Injections of Insulin in the UK: A Retrospective Observational Study.

作者信息

Adamson Karen A, Gibb Fraser W, McLaren James, Min Thinzar, Price Hermione, Sankaranarayanan Sailesh, Strzelecka Anna

机构信息

Department of Diabetes and Endocrinology, Forth Valley Royal Hospital, NHS Forth Valley, Stirling Road, Larbert, FK5 4WR, Scotland.

Edinburgh Centre for Endocrinology and Diabetes, NHS Lothian, Edinburgh, Scotland.

出版信息

Diabetes Ther. 2024 Sep;15(9):2109-2118. doi: 10.1007/s13300-024-01629-z. Epub 2024 Aug 5.

Abstract

INTRODUCTION

There is a growing body of evidence demonstrating the benefit of flash glucose monitoring in people living with type 2 diabetes mellitus (T2DM). This real-world study aimed to evaluate the effect of initiating flash glucose monitoring on change in HbA1c after 3-6 months in adults living with T2DM treated with multiple daily injections of insulin.

METHODS

A retrospective observational study using data from ten clinical centres in the UK for adults with T2DM treated with multiple daily injections of insulin for at least 1 year was conducted. Patients who had been using the FreeStyle Libre/Libre 2 Flash Glucose Monitoring System for at least 3 months with baseline HbA1c 64-108 mmol/mol (8.0-12.0%) recorded up to 3 months prior to system use were included. Pregnant patients and those on dialysis were excluded. Patients with an HbA1c value measured 3-6 months after commencing flash glucose monitoring were included in the final analysis for evaluation of change.

RESULTS

In total, 87 patients were included in the final analysis (mean age, 60.0 ± 11.8 years, 60.9% male, mean body mass index (BMI), 31.6 ± 5.4 [mean ± SD]). From a mean baseline HbA1c of 80 ± 11 mmol/mol (9.5% ± 1.0%), HbA1c lowered by 11 ± 14 mmol/mol (1.0% ± 1.3%) at 3-6 months (p < 0.0001). A decrease was observed independent of age, baseline HbA1c, sex, duration of insulin use and BMI subgroups.

CONCLUSIONS

Initiation of flash glucose monitoring was associated with a clinically and statistically significant improvement in HbA1c in a real-world setting at 3-6 months.

摘要

引言

越来越多的证据表明,动态血糖监测对2型糖尿病(T2DM)患者有益。这项真实世界研究旨在评估在接受每日多次胰岛素注射治疗的成年T2DM患者中,启动动态血糖监测3至6个月后对糖化血红蛋白(HbA1c)变化的影响。

方法

进行了一项回顾性观察研究,使用英国十个临床中心的数据,研究对象为接受每日多次胰岛素注射治疗至少1年的成年T2DM患者。纳入在使用FreeStyle Libre/Libre 2动态血糖监测系统至少3个月且系统使用前3个月内记录的基线HbA1c为64 - 108 mmol/mol(8.0 - 12.0%)的患者。排除孕妇和接受透析的患者。启动动态血糖监测3至6个月后测量HbA1c值的患者纳入最终分析以评估变化情况。

结果

最终分析共纳入87例患者(平均年龄60.0 ± 11.8岁,男性占60.9%,平均体重指数(BMI)为31.6 ± 5.4 [均值 ± 标准差])。基线HbA1c平均为80 ± 11 mmol/mol(9.5% ± 1.0%),在3至6个月时HbA1c降低了11 ± 14 mmol/mol(1.0% ± 1.3%)(p < 0.0001)。观察到的降低与年龄、基线HbA1c、性别、胰岛素使用时长和BMI亚组无关。

结论

在真实世界环境中,启动动态血糖监测在3至6个月时与HbA1c在临床和统计学上的显著改善相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c17b/11330429/2cb6b4524c88/13300_2024_1629_Fig1_HTML.jpg

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