Krakauer Marcio, Travassos Solange, Rodacki Melanie, Gabbay Monica A L, Vianna André G D, Scharf Mauro, Lamounier Rodrigo N, Franco Denise Reis, Araújo Levimar Rocha, Calliari Luis Eduardo
Sociedade Brasileira de Diabetes, São Paulo, Brazil.
Internal Medicine Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Diabetol Metab Syndr. 2025 Jul 16;17(1):276. doi: 10.1186/s13098-025-01797-3.
Attaining an adequate glycemic control has been associated with a better prognosis and with a reduction in the risk of developing long-term microvascular and macrovascular diabetic complications. Continuous glucose monitoring (CGM) has been shown to improve glycemic control and reduce blood glucose variability. Furthermore, CGM is associated with greater treatment adherence and higher satisfaction. Hypoglycemia is the most frequent acute complication in individuals with insulin treated diabetes and may limit the achievement of glycemic control. Furthermore, repeated episodes of hypoglycemia, particularly when a severe hypoglycemia event occurs are associated with adverse outcomes. The introduction of glucose alarms improves not only safety of subjects, but also contributes to improve glycemic control. However, depending on the glycemic thresholds, the frequency of alarms could be perceived as excessive, leading to a state of 'alarm fatigue', limiting the effective response to the alarms by the individual. The optimization of alarm thresholds tailored to individual needs and preferences can enhance the clinical utility of CGM while minimizing alarm fatigue. When alarms occur, their underlying causes should be investigated to enable appropriate corrections and adjustments. CGM systems equipped with alarms, such as FreeStyle Libre 2, have demonstrated efficacy in reducing hyperglycemia and severe hypoglycemic events, leading to improvements in time in range and quality of life of people with diabetes.
实现充分的血糖控制与更好的预后以及降低发生糖尿病长期微血管和大血管并发症的风险相关。连续血糖监测（CGM）已被证明可改善血糖控制并减少血糖变异性。此外，CGM与更高的治疗依从性和更高的满意度相关。低血糖是接受胰岛素治疗的糖尿病患者最常见的急性并发症，可能会限制血糖控制的实现。此外，反复发生低血糖，尤其是发生严重低血糖事件时，与不良后果相关。葡萄糖警报的引入不仅提高了受试者的安全性，还有助于改善血糖控制。然而，根据血糖阈值，警报频率可能会被认为过高，导致“警报疲劳”状态，限制个体对警报的有效反应。根据个体需求和偏好优化警报阈值可以提高CGM的临床效用，同时将警报疲劳降至最低。当警报发生时，应调查其潜在原因，以便进行适当的纠正和调整。配备警报的CGM系统，如FreeStyle Libre 2，已证明在减少高血糖和严重低血糖事件方面有效，从而改善了糖尿病患者的血糖达标时间和生活质量。
