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间歇性扫描式连续血糖监测在老年人中的疗效:一项病例对照研究。

The efficacy of intermittent scanning continuous glucose monitoring in the elderly: A case-control study.

作者信息

Been Riemer A, van Helsdingen Max R X, Zammit Darren, Grzegorczyk Marco, Krijnen Wim P, Tamasi Katalin, Gans Rijk O B, van Beek André P, van Dijk Peter R

机构信息

Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

Department of Mathematics, University of Groningen, Groningen, The Netherlands.

出版信息

Diabetes Obes Metab. 2025 Jul;27(7):3882-3890. doi: 10.1111/dom.16417. Epub 2025 May 13.

Abstract

AIMS

The efficacy of intermittently scanning continuous glucose monitoring (is-CGM) technology among elderly people with diabetes mellitus (DM) has been understudied. We investigated if the initiation of is-CGM results in improved glycemic control among this population.

MATERIALS AND METHODS

Retrospective, observational case-control study. Cases were selected randomly from the DM outpatient clinic of the University Medical Center Groningen between 2015 and 2022 if they had type 1 or type 2 DM, were registered users of is-CGM devices and were aged 60 or older at initiation of those devices. They were matched to randomly selected controls with no CGM usage based on age, gender, DM type and treatment type (insulin-pen or pump). Data were collected at baseline, 6 months prior and 3, 6, 9, 12 and 24 months after initiation. Linear mixed-effects regression was performed to assess the effects of is-CGM usage on HbA1c.

RESULTS

Three hundred and fifty-three participants were analysed (142 cases, 211 controls). Median HbA1c at baseline for is-CGM users was 8.00% [7.20%-9.10%] and for controls 7.90% [7.10%-8.70%]. Unadjusted analysis showed significant reductions of HbA1c 3 months after initialization (cases vs. controls, -0.50% vs. -0.02%, p = 0.016), persisting throughout the study. Adjusting for confounders, is-CGM initiation resulted in significant HbA1c reductions after 6 months (-0.29%, p = 0.006) up until 24 months (-0.39%, p = 0.033). The rate of sensor discontinuation was 2.8%.

CONCLUSIONS

The use of is-CGM improves glycemic control in elderly (≥60 years old) persons with DM after 3 months, and this persists for at least 24 months. The number of discontinuations is low. This data emphasizes the positive impact of is-CGM on the elderly population with DM.

摘要

目的

间歇性扫描式动态血糖监测(is-CGM)技术在老年糖尿病患者中的疗效研究不足。我们调查了启动is-CGM是否能改善该人群的血糖控制。

材料与方法

回顾性观察性病例对照研究。病例从2015年至2022年期间格罗宁根大学医学中心糖尿病门诊随机选取,入选标准为患有1型或2型糖尿病,是is-CGM设备的注册用户,且在启动该设备时年龄在60岁及以上。根据年龄、性别、糖尿病类型和治疗类型(胰岛素笔或胰岛素泵)将他们与随机选取的未使用CGM的对照组进行匹配。在基线、启动前6个月以及启动后3、6、9、12和24个月收集数据。进行线性混合效应回归以评估使用is-CGM对糖化血红蛋白(HbA1c)的影响。

结果

共分析了353名参与者(142例病例,211名对照)。is-CGM用户基线时的HbA1c中位数为8.00%[7.20%-9.10%],对照组为7.90%[7.10%-8.70%]。未调整分析显示,初始化后3个月HbA1c显著降低(病例组与对照组,-0.50%对-0.02%,p=0.016),且在整个研究过程中持续存在。在对混杂因素进行调整后,启动is-CGM导致6个月后HbA1c显著降低(-0.29%,p=0.006),直至24个月(-0.39%,p=0.033)。传感器停用率为2.8%。

结论

使用is-CGM可在3个月后改善老年(≥60岁)糖尿病患者的血糖控制,且这种改善至少持续24个月。停用数量较少。这些数据强调了is-CGM对老年糖尿病患者的积极影响。

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