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糖化血红蛋白(HbA1c)与血糖监测在目标范围内的持续时间的相关性

Correlation of HbA1c and Continuous Glucose Monitor Time in Range.

作者信息

DePasquale Hannah, DeLucenay Alexander, Ahmed-Sarwar Nabila

机构信息

Center for Advanced Heart Failure and Mechanical Circulatory Support, Rochester Regional Health, Rochester, NY, USA.

Wegmans School of Pharmacy, St. John Fisher University, Rochester, NY, USA.

出版信息

J Pharm Technol. 2025 Jun 24:87551225251348832. doi: 10.1177/87551225251348832.

Abstract

Current literature is limited to describing the correlation of continuous glucose monitor (CGM) use and improved HbA1cs in patients with type 2 diabetes. There is a lack of literature correlating HbA1c and time in range (TIR). In addition, data such as time spent with low or very low blood glucose levels are not assessed in existing literature. To assess the correlation between reduction of HbA1c and increase in TIR for patients using CGMs meeting with an interdisciplinary team. This retrospective chart review includes adult patients seen in an interdisciplinary internal medicine clinic consisting of a pharmacist and nurse practitioner. Data collection included patients with diabetes using CGMs for at least 3 months, who had a visit with the team in the last 12 months. Information collected included demographics, insurance, comorbidities, diabetes medications, HbA1c and CGM data at baseline and 3-month visit, and number of pharmacist medication interventions. Fisher's exact, chi-square, and Mann-Whitney tests were used where appropriate. HbA1c decreased from 8.6% to 7.5% 3 months later ( = 0.002). The average increase in TIR was 55.5% to 65.1% ( = 0.007). The overall decrease in HbA1c and increase in TIR had a high inverse correlation at baseline and 3 months ( = -0.7 and = -0.7, < 0.001). There is a strong inverse relationship between HbA1c and TIR, reduction in glucose variability with a slightly higher incidence time in low/very low following intervention. The type and frequency of pharmacist-initiated interventions support the clinical decision-making potential for pharmacotherapy adjustments.

摘要

目前的文献仅限于描述连续血糖监测(CGM)的使用与2型糖尿病患者糖化血红蛋白(HbA1c)改善之间的相关性。缺乏将HbA1c与血糖达标时间(TIR)相关联的文献。此外,现有文献中未评估低血糖或极低血糖水平所花费的时间等数据。为了评估使用CGM并与跨学科团队会诊的患者中HbA1c降低与TIR增加之间的相关性。这项回顾性病历审查纳入了在由药剂师和执业护士组成的跨学科内科诊所就诊的成年患者。数据收集包括使用CGM至少3个月、在过去12个月内与该团队进行过就诊的糖尿病患者。收集的信息包括人口统计学、保险、合并症、糖尿病药物、基线和3个月就诊时的HbA1c和CGM数据,以及药剂师药物干预的次数。在适当情况下使用Fisher精确检验、卡方检验和Mann-Whitney检验。3个月后HbA1c从8.6%降至7.5%(P = 0.002)。TIR的平均增加为55.5%至65.1%(P = 0.007)。HbA1c的总体降低和TIR的增加在基线和3个月时具有高度负相关性(r = -0.7和r = -0.7,P < 0.001)。HbA1c与TIR之间存在很强的负相关关系,干预后血糖变异性降低,低/极低血糖发生时间略有增加。药剂师发起的干预的类型和频率支持药物治疗调整的临床决策潜力。

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