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间歇性扫描式动态血糖监测应用于接受非胰岛素治疗的2型糖尿病患者血糖控制的效果——一项随机对照试验

Effect of introduction of intermittently scanned continuous glucose monitoring on glycaemic control in individuals living with type 2 diabetes mellitus treated with non-insulin therapies-A randomised controlled trial.

作者信息

Ssemmondo Emmanuel, Shah Najeeb, Newham Milly, Rigby Alan, Buckland Rachel, Deshmukh Harshal, Sathyapalan Thozhukat

机构信息

Allam Diabetes Centre, University of Hull, Kingston upon Hull, UK.

Hull University Teaching Hospitals NHS Trust, Kingston upon Hull, UK.

出版信息

Diabetes Obes Metab. 2025 Mar;27(3):1226-1232. doi: 10.1111/dom.16116. Epub 2024 Dec 11.

Abstract

AIMS

This pilot randomised controlled trial aimed to evaluate the effect of introducing isCGM on glycaemic control and diabetes distress in individuals with T2DM receiving non-insulin therapies.

MATERIALS AND METHODS

Forty adults with T2DM were randomised to either receive FreeStyle Libre 2 (Libre 2), an isCGM system, or FreeStyle Libre Pro iQ (Libre Pro) also known as 'blinded' CGM. Participants were followed for 12 weeks. The primary outcome was a fall in haemoglobin A1c (HbA1c) of ≥5.5 mmol/mol. Diabetes distress was assessed using the two-item diabetes distress scale (DDS2).

RESULTS

The median age was 59.5 years; 57.5% were male. Of the Libre 2 users, 53% achieved a ≥5.5 mmol/mol reduction in HbA1c compared to 35% in the Libre pro group (p = 0.34). Compared to Libre Pro, the use of Libre 2 was associated with an improved time in range at 12 weeks of 18 percentage points (confidence interval 2-35, p = 0.028). Participants in the Libre 2 group exhibited a non-significant reduction in HbA1c levels of 8 mmol/mol compared to the Libre Pro group after 12 weeks. However, no significant differences were observed in other CGM metrics or diabetes distress between the study groups.

CONCLUSIONS

The use of isCGM in individuals living with T2DM on non-insulin therapy showed promise in improving glycaemic control, as evidenced by increased TIR, albeit without a significant reduction in HbA1c or impact on diabetes distress, suggesting this could be potentially beneficial in individuals with T2DM.

摘要

目的

本项试点随机对照试验旨在评估引入实时连续葡萄糖监测(isCGM)对接受非胰岛素治疗的2型糖尿病(T2DM)患者血糖控制及糖尿病困扰的影响。

材料与方法

40名成年T2DM患者被随机分为两组,一组接受实时连续葡萄糖监测系统FreeStyle Libre 2(Libre 2),另一组接受FreeStyle Libre Pro iQ(Libre Pro,即“盲法”连续葡萄糖监测)。对参与者进行为期12周的随访。主要结局指标为糖化血红蛋白(HbA1c)下降≥5.5 mmol/mol。使用两项糖尿病困扰量表(DDS2)评估糖尿病困扰情况。

结果

中位年龄为59.5岁;57.5%为男性。在Libre 2使用者中,53%的患者HbA1c降低了≥5.5 mmol/mol,而Libre pro组这一比例为35%(p = 0.34)。与Libre Pro相比,使用Libre 2使12周时血糖处于目标范围内的时间改善了18个百分点(置信区间2 - 35,p = 0.028)。12周后,Libre 2组参与者的HbA1c水平与Libre Pro组相比非显著降低了8 mmol/mol。然而,研究组之间在其他连续葡萄糖监测指标或糖尿病困扰方面未观察到显著差异。

结论

在接受非胰岛素治疗的T2DM患者中使用isCGM在改善血糖控制方面显示出前景,血糖在目标范围内时间(TIR)增加证明了这一点,尽管HbA1c没有显著降低,也未对糖尿病困扰产生影响,这表明其对T2DM患者可能具有潜在益处。

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