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2型新诊断糖尿病患者的远程血糖监测与糖化血红蛋白改善:一项基于社区的多中心研究。

Remote glucose monitoring and HbA1c improvement among persons with newly diagnosed diabetes mellitus type 2: A multi-center community-based study.

作者信息

Khan Mehreen, Gigoyan Lusine, Reed Mary

机构信息

Department of Endocrinology, Kaiser Permanente Santa Clara, 710 Lawrence Expressway, Santa Clara, CA, 95051, USA.

Division of Research, Kaiser Permanente Northern California, 4480 Hacienda Drive, Pleasanton, CA, 94588, USA.

出版信息

Metabol Open. 2025 Mar 5;26:100355. doi: 10.1016/j.metop.2025.100355. eCollection 2025 Jun.

Abstract

AIMS

Remote monitoring can support patients with Type II diabetes. Still, evidence for improved glucose outcomes in broad community practice patients is extremely limited. We examined remote glucose monitoring in newly diagnosed patients with diabetes to identify its impact on diabetes outcomes.

METHODS

In a retrospective cohort study of all adults (age 18-75) with newly diagnosed Type II diabetes February 2020-December 2021 in a large integrated health system, we compared HbA1c (units: percentage, %) outcomes in remote monitoring users to non-users in their first year with diabetes, using propensity-weighted analyses.

RESULTS

Among 35,958 patients, patients age 45+ (vs. age 18-34), who were Asian/Pacific Islander or Hispanic (compared to White), living in more deprived neighborhoods, not using the patient portal, or with baseline HbA1c ≤ 8 were significantly (p < 0.001) less likely to use remote glucose monitoring. After adjustment, remote monitoring use was associated with a 23 % (95 % CI: 17-29 %) higher rate of reaching the HbA1c ≤ 8 % (vs. non-users). In patients starting with HbA1c > 8, remote glucose monitoring use was associated with 0.93 % greater absolute improvement in HbA1c value (vs. non-users, p < 0.05).

CONCLUSIONS

Remote glucose monitoring was associated with improved HbA1c among newly diagnosed patients with Type II diabetes.

摘要

目的

远程监测可为2型糖尿病患者提供支持。然而,在广泛的社区实践患者中,关于改善血糖结果的证据极为有限。我们研究了新诊断糖尿病患者的远程血糖监测,以确定其对糖尿病结局的影响。

方法

在一项对2020年2月至2021年12月在一个大型综合医疗系统中所有新诊断为2型糖尿病的成年人(年龄18 - 75岁)的回顾性队列研究中,我们使用倾向加权分析比较了远程监测使用者和非使用者在糖尿病第一年的糖化血红蛋白(单位:百分比,%)结果。

结果

在35958名患者中,45岁及以上(与18 - 34岁相比)、亚洲/太平洋岛民或西班牙裔(与白人相比)、生活在更贫困社区、未使用患者门户网站或基线糖化血红蛋白≤8%的患者使用远程血糖监测的可能性显著降低(p < 0.001)。调整后,使用远程监测与糖化血红蛋白≤8%的达标率提高23%(95%置信区间:17 - 29%)相关(与非使用者相比)。在起始糖化血红蛋白>8%的患者中,使用远程血糖监测与糖化血红蛋白值的绝对改善幅度高0.93%相关(与非使用者相比,p < 0.05)。

结论

远程血糖监测与新诊断的2型糖尿病患者糖化血红蛋白的改善相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f99f/11938046/0f975ad9a999/gr1.jpg

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