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1型糖尿病成人患者使用不同治疗方式时的血糖指标与设备满意度:一项多中心、真实世界观察性研究

Glucose metrics and device satisfaction in adults with type 1 diabetes using different treatment modalities: a multicenter, real-world observational study.

作者信息

Molfetta S Di, Rossi A, Gesuita R, Faragalli A, Cutruzzolà A, Irace C, Minuto N, Pitocco D, Cardella F, Arnaldi C, Frongia A, Mozzillo E, Predieri B, Fiorina P, Giorgino F, Cherubini V

机构信息

Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro, Bari, 70124, Italy.

IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, 20157, Italy.

出版信息

Acta Diabetol. 2025 Apr;62(4):563-573. doi: 10.1007/s00592-024-02381-3. Epub 2024 Oct 10.

Abstract

AIMS

To evaluate glucose metrics, device satisfaction and diabetes impact in adults with type 1 diabetes using different treatment modalities in a real-life setting in Italy.

METHODS

This was a multicentre, nationwide, cross-sectional study. Candidates were consecutively evaluated for eligibility during their routine medical visit at the diabetes centre. Researchers collected comprehensive demographic, socioeconomic, anamnestic and clinical data, and administered the Diabetes Impact and Device Satisfaction scale.

RESULTS

From 2021 to 2022, a total of 428 subjects, 45% males, with a median age of 32 years (IQR 23-47) were recruited in 11 participating centres from all over Italy. No differences in age, physical activity, and diabetes impact were found for the different treatment modalities. HCL/AHCL and SAP groups reported higher device satisfaction vs. MDI + SMBG and MDI + CGM (p < 0.001). Subjects treated with HCL/AHCL exhibited significantly higher TIR and significantly lower time spent in hypoglycemia level 1, time spent in hyperglycemia, CV and GMI compared to MDI + CGM, and significantly higher TIR and significantly lower time spent in hypoglycemia level 2, time spent in hyperglycemia, and CV compared to SAP. Significant reduction in hypoglycemia level 2 was also found with PLGM compared to SAP. High education attainment was associated with optimal metabolic control.

CONCLUSION

Real-life use of advanced technologies for type 1 diabetes is associated with improved glucose metrics and device satisfaction. Education level also contributes to success of treatment.

摘要

目的

在意大利的实际生活环境中,评估使用不同治疗方式的1型糖尿病成年患者的血糖指标、设备满意度和糖尿病影响。

方法

这是一项多中心、全国性的横断面研究。在糖尿病中心的常规就诊期间,对候选人进行连续的资格评估。研究人员收集了全面的人口统计学、社会经济、既往史和临床数据,并进行了糖尿病影响和设备满意度量表的评估。

结果

2021年至2022年,来自意大利各地的11个参与中心共招募了428名受试者,其中45%为男性,中位年龄为32岁(四分位间距23 - 47岁)。不同治疗方式在年龄、身体活动和糖尿病影响方面未发现差异。与MDI + SMBG和MDI + CGM相比,HCL/AHCL和SAP组报告的设备满意度更高(p < 0.001)。与MDI + CGM相比,接受HCL/AHCL治疗的受试者的总体达标时间(TIR)显著更高,低血糖1级时长、高血糖时长、血糖波动幅度(CV)和糖化血红蛋白(GMI)显著更低;与SAP相比,TIR显著更高,低血糖2级时长、高血糖时长和CV显著更低。与SAP相比,持续葡萄糖监测(PLGM)的低血糖2级也有显著降低。高学历与最佳代谢控制相关。

结论

1型糖尿病患者在实际生活中使用先进技术与改善血糖指标和设备满意度相关。教育水平也有助于治疗成功。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07da/12055876/4191a1793679/592_2024_2381_Fig1_HTML.jpg

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