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对于使用 MDI 的 1 型糖尿病患者,在严格控制范围内的时间是否有目标值?来自掩蔽 CGM 的数据。

Is there a target value for time in tight range for individuals with type 1 diabetes on MDI? Data from masked CGM.

机构信息

Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.

Higashitotsuka Diabetes Internal Medicine Clinic, Yokohama, Kanagawa, Japan.

出版信息

Expert Rev Endocrinol Metab. 2024 Nov;19(6):507-512. doi: 10.1080/17446651.2024.2400487. Epub 2024 Sep 5.

Abstract

OBJECTIVE

Time in Tight Range (TITR), defined as the percentage of time within the glucose range of 70 to 140 mg/dL, is anticipated to be challenging to maintain without causing hypoglycemia, especially in individuals with type 1 diabetes (T1D). This study aimed to investigate the TITR target value in individuals with T1D on multiple daily injections (MDI).

METHODS

The study included 101 individuals with T1D on MDI aged 15 to 75 who were hospitalized at Jikei University School of Medicine from September 2006 to November 2013 to conduct Continuous Glucose Monitoring (CGM). The cutoff values of TITR for predicting the attainment of GMI < 7.0%, and TBR < 4% were determined using Receiver Operating Characteristic (ROC) curves.

RESULTS

The TITR cutoff value was calculated to be 41% (sensitivity 81%, specificity 88%) and 40% (54%,72%) for predicting GMI < 7.0% and TBR < 4%.

CONCLUSIONS

In individuals with T1D on MDI without devices capable of preventing hypoglycemia, it is recommended to target TITR at 40% to address the risk of increased hypoglycemia sufficiently.

摘要

目的

时间在严格范围内(TITR),定义为血糖在 70 至 140mg/dL 范围内的时间百分比,预计在不引起低血糖的情况下很难维持,特别是在 1 型糖尿病(T1D)患者中。本研究旨在调查接受多次皮下注射(MDI)的 T1D 患者的 TITR 目标值。

方法

该研究纳入了 2006 年 9 月至 2013 年 11 月期间在日本顺天堂大学医学院住院的 101 名接受 MDI 的 T1D 患者,进行连续血糖监测(CGM)。使用受试者工作特征(ROC)曲线确定 TITR 截断值,以预测 GM < 7.0%和 TBR < 4%的达标情况。

结果

TITR 截断值计算为 41%(灵敏度 81%,特异性 88%)和 40%(54%,72%),用于预测 GM < 7.0%和 TBR < 4%。

结论

在没有能够预防低血糖的设备的 T1D 患者接受 MDI 治疗时,建议将 TITR 目标设定为 40%,以充分解决低血糖风险增加的问题。

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