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共病性痴呆与糖尿病患者的连续血糖监测:目前的证据

Continuous Glucose Monitoring in Comorbid Dementia and Diabetes: The Evidence So Far.

作者信息

Donat Ergin Busra, Gadsby-Davis Kieran, Mattishent Katharina, Dhatariya Ketan, Garner Nikki, Hornberger Michael

机构信息

Norwich Medical School, University of East Anglia, Norwich, UK.

Norfolk & Norwich University Hospital, Norwich, UK.

出版信息

J Diabetes Sci Technol. 2024 Dec 18:19322968241301058. doi: 10.1177/19322968241301058.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) and dementia are two of the leading chronic diseases in aging and are known to influence each other's disease progression. There is well-established evidence that T2DM increases the risk for cognitive decline and dementia. At the same time, people with cognitive changes or dementia can find it difficult to manage their diabetes, resulting in hyper- or hypoglycemic events which can exacerbate the dementia disease progression further. Monitoring of glucose variability is, therefore, of critical importance during aging and when people with T2DM develop dementia. The advent of continuous glucose monitoring (CGM) has allowed the monitoring of glucose variability in T2DM more closely. The CGM seems to be highly feasible and acceptable to use in older people with T2DM and has been shown to significantly reduce their hypoglycemic events, often resulting in falls. Less is known as to whether CGM can have a similar beneficial effect on people with T2DM who have cognitive impairment or dementia in community or hospital settings.

AIMS

The current perspective will explore how CGM has made an impact on T2DM management in older people and those with comorbid cognitive impairment or dementia. We will further explore opportunities and challenges of using CGM in comorbid T2DM and dementia in community and hospital settings.

摘要

背景

2型糖尿病(T2DM)和痴呆症是老龄化过程中两种主要的慢性疾病,并且已知它们会相互影响疾病进展。有充分的证据表明,T2DM会增加认知功能下降和痴呆症的风险。与此同时,认知功能发生变化或患有痴呆症的人可能会发现难以控制自己的糖尿病,从而导致高血糖或低血糖事件,这可能会进一步加剧痴呆症的疾病进展。因此,在老龄化过程中以及T2DM患者发生痴呆症时,监测血糖变异性至关重要。连续血糖监测(CGM)的出现使得能够更密切地监测T2DM患者的血糖变异性。CGM在老年T2DM患者中使用似乎非常可行且可接受,并且已被证明能显著减少他们的低血糖事件,而低血糖事件常常会导致跌倒。对于CGM在社区或医院环境中对患有认知障碍或痴呆症的T2DM患者是否能产生类似的有益效果,人们了解得较少。

目的

本观点将探讨CGM如何对老年人以及患有合并认知障碍或痴呆症的患者的T2DM管理产生影响。我们还将进一步探讨在社区和医院环境中,在合并T2DM和痴呆症的情况下使用CGM的机遇和挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e99/11653377/2f15cf4c7c04/10.1177_19322968241301058-fig1.jpg

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