Navrátilová Vendula, Zadáková Eliška, Šoupal Jan, Škrha Jan, Do Quoc Dat, Radovnická Lucie, Hásková Aneta, Prázný Martin, Horová Eva
3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Department of Internal Medicine, Masaryk Hospital, Ústí nad Labem, Czech Republic.
Endocrinol Diabetes Metab. 2025 Mar;8(2):e70047. doi: 10.1002/edm2.70047.
To determine whether people with type 1 diabetes (T1D) initiating glucose sensor monitoring experience greater improvements in HbA1c when provided with education on carbohydrate counting and flexible insulin dosing than those who do not receive nutrition education.
Our retrospective observational study included 329 people with T1D initiating glucose sensor monitoring between 2015 and 2021. The participants were divided into two groups: one group attended at least one structured educational session with a registered dietitian (n = 126), while the other group did not receive structured education (n = 203). After 12 months of glucose sensor initiation, we compared glycaemic outcomes and CGM metrics between the two groups.
At glucose sensor initiation, both groups with and without education had similar HbA1c levels (7.64% [60.0 mmol/mol] vs. 7.66% [60.2 mmol/mol]). After twelve months, the education group demonstrated greater improvement in glycemic outcomes (HbA1c 7.17% [54.9mmol/mol] vs. 7.37% [57.1 mmol/mol], p < 0.05) and spent significantly more time in the target range than did the group without structured education (68.8% vs. 64.1%, p < 0.05). We observed an inverse correlation between the number of completed educational sessions and HbA1c after 12 months, as well as between the number of educational sessions and the change in HbA1c.
People with T1D who initiated glucose sensor monitoring alongside nutrition education showed greater improvements in HbA1c and increased time spent in the target glucose range compared to individuals who did not receive structured education.
ClinicalTrials.gov identifier: NCT06264271.
确定与未接受营养教育的1型糖尿病（T1D）患者相比，开始使用葡萄糖传感器监测并接受碳水化合物计数和灵活胰岛素剂量教育的患者糖化血红蛋白（HbA1c）改善是否更大。
我们的回顾性观察研究纳入了2015年至2021年间开始使用葡萄糖传感器监测的329例T1D患者。参与者分为两组：一组参加了至少一次由注册营养师进行的结构化教育课程（n = 126），而另一组未接受结构化教育（n = 203）。在开始使用葡萄糖传感器12个月后，我们比较了两组的血糖结果和连续血糖监测（CGM）指标。
开始使用葡萄糖传感器时，接受教育组和未接受教育组的HbA1c水平相似（7.64% [60.0 mmol/mol] 对7.66% [60.2 mmol/mol]）。十二个月后，接受教育组在血糖结果方面有更大改善（HbA1c 7.17% [54.9 mmol/mol] 对7.37% [57.1 mmol/mol]，p < 0.05），且在目标范围内花费的时间明显多于未接受结构化教育组（68.8% 对64.1%，p < 0.05）。我们观察到12个月后完成的教育课程数量与HbA1c之间以及教育课程数量与HbA1c变化之间呈负相关。
与未接受结构化教育的个体相比，开始使用葡萄糖传感器监测并接受营养教育的T1D患者HbA1c改善更大，且在目标血糖范围内花费的时间增加。
ClinicalTrials.gov标识符：NCT06264271。
