Shen Long, Xu Li, Zhang Chen, Gong Wei-Wei, Jing Xiao-Ting, Cao Min-Jia, Shi Fang-Hong, Pu Jun
Department of Cardiology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Nursing, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Digit Health. 2024 Oct 3;10:20552076241287842. doi: 10.1177/20552076241287842. eCollection 2024 Jan-Dec.
The objective of this study was to assess the accuracy of FreeStyle Libre Pro (FSL-Pro) flash continuous glucose monitoring (CGM) in patients with type 2 diabetes mellitus (T2DM) and acute myocardial infarction (AMI).
A single-arm, single-center prospective study was conducted in the cardiac care unit from January 2021 to September 2023. Patients underwent finger-prick blood glucose (FPBG) testing before breakfast (6:00 am) and after meals (at 9:00, 13:00, 19:00 pm), along with CGM during their hospitalization. Statistical analyses included mean differences (MDs), mean absolute relative difference (MARDs) of blood glucose levels, and hypoglycemia occurrences. A Bland-Altman plot analysis and Pearson correlation were performed.
Ninety-seven T2DM and AMI patients underwent CGM for up to 72 h (1142 monitoring point). Mean daily BG, Fasting plasma glucose (FPG) and mean postprandial plasma glucose (PPG) were significantly lower by CGM than by FPBG with an estimated MD of -0.89 mmol/L in BG, -0.88 mmol/L in FPG, and -0.90 mmol/L in PPG, respectively. The maximum effect was mainly in the first day and then the difference was gradually declined (falling range, Day1, -1.24; Day 2, -0.70; Day 3, -0.68, mmol/L, respectively). The incidence rates of hypoglycemia and potential hypoglycemia was 1.57% and 8.5% higher, respectively, in CGM than in FBPG. A Bland-Altman Plot revealed some variability and bias between the two methods of measurement of glucose monitoring (< .001). Pearson's correlation coefficient demonstrated a significant correlation between the mean BG, FPG, and PPG of CGM and FBPG (Pearson's coefficient: 0.92, 0.87, 0.92, respectively, < .001).
Compared with FPBG, FSL Pro-CGM showed lower mean glucose and higher hypoglycemia detection in T2DM and AMI patients, especially in the first 24 h.
本研究的目的是评估FreeStyle Libre Pro（FSL-Pro）闪光连续血糖监测（CGM）在2型糖尿病（T2DM）合并急性心肌梗死（AMI）患者中的准确性。
2021年1月至2023年9月在心脏监护病房进行了一项单臂、单中心前瞻性研究。患者在早餐前（上午6:00）和餐后（上午9:00、下午13:00、晚上19:00）进行指尖血糖（FPBG）检测，并在住院期间进行CGM监测。统计分析包括血糖水平的平均差异（MDs）、平均绝对相对差异（MARDs）以及低血糖发生情况。进行了Bland-Altman图分析和Pearson相关性分析。
97例T2DM合并AMI患者接受了长达72小时的CGM监测（1142个监测点）。CGM测得的每日平均血糖、空腹血糖（FPG）和餐后平均血糖（PPG）显著低于FPBG，估计血糖MD为-0.89 mmol/L，FPG为-0.88 mmol/L，PPG为-0.90 mmol/L。最大影响主要在第一天，之后差异逐渐减小（下降幅度分别为：第1天，-1.24；第2天，-0.70；第3天，-0.68 mmol/L）。CGM监测的低血糖和潜在低血糖发生率分别比FBPG高1.57%和8.5%。Bland-Altman图显示两种血糖监测方法之间存在一些变异性和偏差（<0.001）。Pearson相关系数表明CGM和FBPG的平均血糖、FPG和PPG之间存在显著相关性（Pearson系数分别为：0.92、0.87、0.92，<0.001）。
与FPBG相比，FSL Pro-CGM在T2DM合并AMI患者中显示出较低的平均血糖水平和较高的低血糖检测率，尤其是在最初24小时内。
