Wang Qinbo, Zhou Yuan, Wang Wanzhen, Ou Yingjuan, Wu Xia, Chen Junrong, Li Xiaoyan, Li Hua
Department of Pharmacy, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Graceland Medical Center, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
Front Med (Lausanne). 2025 Jun 3;12:1464071. doi: 10.3389/fmed.2025.1464071. eCollection 2025.
This study aimed to evaluate the impact of Continuous Glucose Monitoring (CGM) on enhanced recovery after surgery (ERAS) outcomes in colorectal cancer (CRC) patients with type 2 diabetes mellitus (T2DM).
We conducted an observational cohort study of adult patients (≥18 years) with T2DM undergoing abdominal surgery for pathologically confirmed CRC. Exclusion criteria included history of other malignancies, preoperative infections, or incomplete clinical data. Participants were stratified into two groups: the exposed group (CGM monitoring) and the control group (conventional glucose analyzer [CGA]). Primary outcomes included glycemic variability, surgical complications, ERAS milestones, and patient satisfaction scores.
Among 181 enrolled patients (CGM = 81, CGA = 100), CGM demonstrated superior glycemic control compared to CGA, with significantly lower mean daily glucose levels at postoperative day 1 (9.52 ± 2.53 vs. 10.37 ± 2.26 mmol/L, < 0.05) and day 3 (9.36 ± 1.82 vs. 10.64 ± 1.84 mmol/L, < 0.05). The CGM group showed better clinical outcomes including improved anastomotic healing ( < 0.05), shorter time to first flatus ( < 0.05), and reduced length of hospitalization ( < 0.05). Patient satisfaction scores were significantly higher in the CGM group (32.42 ± 3.33 vs. 29.81 ± 2.98, < 0.05).
CGM provides superior perioperative glucose monitoring in diabetic CRC patients, particularly during the critical 72-h postoperative period. The technology facilitates early detection of acute hyperglycemia, promotes wound healing, and accelerates recovery within ERAS protocols. These findings support the clinical value of CGM implementation in surgical management of T2DM patients with CRC.
本研究旨在评估持续葡萄糖监测（CGM）对2型糖尿病（T2DM）合并结直肠癌（CRC）患者术后加速康复（ERAS）结局的影响。
我们对成年（≥18岁）T2DM患者进行了一项观察性队列研究，这些患者因病理确诊的CRC接受腹部手术。排除标准包括其他恶性肿瘤病史、术前感染或临床数据不完整。参与者被分为两组：暴露组（CGM监测）和对照组（传统血糖仪[CGA]）。主要结局包括血糖变异性、手术并发症、ERAS里程碑指标和患者满意度评分。
在181例入组患者中（CGM组=81例，CGA组=100例），与CGA相比，CGM显示出更好的血糖控制，术后第1天（9.52±2.53 vs. 10.37±2.26 mmol/L，<0.05）和第3天（9.36±1.82 vs. 10.64±1.84 mmol/L，<0.05）的平均每日血糖水平显著更低。CGM组显示出更好的临床结局，包括吻合口愈合改善（<0.05）、首次排气时间缩短（<0.05）和住院时间缩短（<0.05）。CGM组的患者满意度评分显著更高（32.42±3.33 vs. 29.81±2.98，<0.05）。
CGM为糖尿病CRC患者提供了更好的围手术期血糖监测，尤其是在术后关键的72小时内。该技术有助于早期发现急性高血糖，促进伤口愈合，并加速ERAS方案中的康复。这些发现支持了在T2DM合并CRC患者的手术管理中实施CGM的临床价值。
