Kim Kwang Joon, Park Yang Sun, Sun Eunseo, Jo Euna, Shinn Jiwon, Yim Hyeon Woo, Kim Chang Oh, Kim Hun-Sung
Division of Geriatrics, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Institute for Innovation in Digital Healthcare, Severance Hospital Health System, Seoul, Korea.
Yonsei Med J. 2025 Jun;66(6):346-353. doi: 10.3349/ymj.2024.0261.
To investigate whether using a continuous glucose monitoring (CGM) for the second time (2nd_CGM) would be effective after using it for the first time (1st_CGM), depending on age.
This study included patients aged ≥40 years who were diagnosed with type 2 diabetes and had used a CGM at least twice between 2017 and 2021. Participants were divided into two groups based on their age: those aged <60 years and those aged ≥60 years. We assessed the glycemic control status of the 1st_CGM and 2nd_CGM, along with the glycemic variability.
Overall, 15 patients were included in the study. The mean glucose level in users aged <60 years significantly decreased (<0.001) owing to the CGM use, while it did not increase in those aged ≥60 years. In users aged ≥60 years, the 1st_CGM group showed a significant decrease in blood glucose levels over time (<0.05), whereas the 2nd_CGM group only showed a non-significant decreasing trend. The time in range tended to increase in those aged <60 years but decreased in those aged ≥60 years. In those aged <60 years, the mean amplitude of glycemic excursions (<0.001), standard deviation (<0.05), and coefficient of variation (<0.001) significantly decreased. In those aged ≥60 years, these parameters exhibited a non-significant decreasing trend.
Glycemic effect and variability improved as expected with 1st_CGM use. However, 2nd_CGM did not significantly improve glycemic effect or variability in users aged ≥60 years, contrary to expectations. To address this issue, further investigation is needed to understand why, compared to 1st_CGM, 2nd_CGM fails to achieve better glycemic control in individuals aged ≥60 years.
根据年龄，研究在首次使用连续血糖监测（CGM）（1st_CGM）后再次使用（2nd_CGM）是否有效。
本研究纳入了年龄≥40岁、被诊断为2型糖尿病且在2017年至2021年间至少使用过两次CGM的患者。参与者根据年龄分为两组：年龄<60岁的患者和年龄≥60岁的患者。我们评估了1st_CGM和2nd_CGM的血糖控制状况以及血糖变异性。
总体而言，15名患者纳入了本研究。使用CGM后，年龄<60岁的使用者的平均血糖水平显著下降（<0.001），而年龄≥60岁的使用者的平均血糖水平没有升高。在年龄≥60岁的使用者中，1st_CGM组的血糖水平随时间显著下降（<0.05），而2nd_CGM组仅显示出不显著的下降趋势。血糖在目标范围内的时间在年龄<60岁的使用者中趋于增加，但在年龄≥60岁的使用者中则减少。在年龄<60岁的使用者中，血糖波动平均幅度（<0.001）、标准差（<0.05）和变异系数（<0.001）显著下降。在年龄≥60岁的使用者中，这些参数呈现出不显著的下降趋势。
正如预期的那样，首次使用CGM时血糖效应和变异性得到改善。然而，与预期相反，第二次使用CGM并没有显著改善年龄≥60岁使用者的血糖效应或变异性。为了解决这个问题，需要进一步研究以弄清楚为什么与首次使用CGM相比，第二次使用CGM在年龄≥60岁的个体中未能实现更好的血糖控制。
