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非重症新冠肺炎住院患者自我校准连续血糖监测的实用性和准确性前瞻性研究

Prospective Study on Self-Calibrating Continuous Glucose Monitoring Practicality and Accuracy in Noncritically Ill COVID-19 Hospitalized Patients.

作者信息

Sakjirapapong Choompunuj, Sirinvaravong Sirinart, Preechasuk Lukana, Thongtang Nuntakorn

机构信息

Department of Medicine, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.

Diabetes, Thyroid and Endocrine Center, Phyathai2 International Hospital, Bangkok, Thailand.

出版信息

J Diabetes Res. 2025 Aug 21;2025:7538573. doi: 10.1155/jdr/7538573. eCollection 2025.

Abstract

This study is aimed at evaluating the accuracy and feasibility of real-time continuous glucose monitoring (rt-CGM) in non-ICU hospitalized adult COVID-19 patients who had hyperglycemia requiring insulin therapy during admission. Medtronic Guardian Sensor 3 and transmitter were placed on the patient's abdomen. The patient performed a self-calibration of CGM via the application installed in the smartphone. Paired CBG and sensor glucose values were analyzed for accuracy of CGM using mean absolute relative difference (MARD) and Clarke error grid analysis (CEGA). Fifteen patients were enrolled. Mean age was 48.6 ± 17.9 years; 53.3% were female. Thirteen patients (86.7%) had pre-existing diabetes. Mean HbA1c was 10.6 ± 3.6%. Mean duration of CGM use was 6 ± 1.2 days, and mean calibration was 2.6 ± 0.7 times/day. There were 253 paired CBG and CGM measurements. The overall MARD was 9.9 ± 9.3%. The lowest MARD was observed in the CBG range of 70-180 mg/dL (9.6 ± 9.0%) and on Day 3 of sensor wear (8.0 ± 4.6%). The percentages of glucose readings within 15/15%, 20/20%, and 30/30% were 81.0%, 89.7%, and 95.3%, respectively. A total of 99.2% of the data points were in Zones A and B of CEGA, and none were in Zone E. CGM reduced POC testing by approximately 30%. Rt-CGM use in hospitalized patients with COVID-19 infection demonstrates high accuracy, reduces the frequency of CBG testing, and preserves medical resources. The patient's self-calibration of rt-CGM in this setting is feasible. Although the COVID-19 pandemic tends to improve, our research could be applied to new emerging infectious diseases. Thai Clinical Trials Registry: TCTR20230426007.

摘要

本研究旨在评估实时连续血糖监测(rt-CGM)在非重症监护病房(ICU)住院的成年COVID-19患者中的准确性和可行性,这些患者在入院期间出现高血糖且需要胰岛素治疗。美敦力Guardian Sensor 3和发射器放置在患者腹部。患者通过智能手机上安装的应用程序对CGM进行自我校准。使用平均绝对相对差(MARD)和克拉克误差网格分析(CEGA)分析配对的毛细血管血糖(CBG)和传感器血糖值,以评估CGM的准确性。共纳入15例患者。平均年龄为48.6±17.9岁;53.3%为女性。13例患者(86.7%)既往有糖尿病。平均糖化血红蛋白(HbA1c)为10.6±3.6%。CGM的平均使用时长为6±1.2天,平均校准次数为2.6±0.7次/天。共有253对CBG和CGM测量值。总体MARD为9.9±9.3%。在CBG范围为70-180mg/dL时观察到最低MARD(9.6±9.0%),且在传感器佩戴第3天时最低(8.0±4.6%)。血糖读数在15/15%、20/20%和30/30%范围内的百分比分别为81.0%、89.7%和95.3%。共有99.2%的数据点位于CEGA的A区和B区,无数据点位于E区。CGM使即时检测次数减少了约30%。在感染COVID-19的住院患者中使用rt-CGM显示出高准确性,减少了CBG检测频率,并节省了医疗资源。在这种情况下患者对rt-CGM进行自我校准是可行的。尽管COVID-19大流行趋势趋于缓解,但我们的研究可应用于新出现的传染病。泰国临床试验注册中心:TCTR20230426007。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8cc4/12393932/7e9f93804849/JDR2025-7538573.001.jpg

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