Dorchy H, Roggemans M P
Diabetes Clinic, Children's University Hospital Queen Fabiola, Brussels, Belgium.
Diabetes Res Clin Pract. 1997 May;36(2):77-82. doi: 10.1016/s0168-8227(97)00034-x.
Recently, Medisense has introduced the Sensorlink system as a tool for retrieving the 125 last results of home blood glucose monitoring stored in patient's Pen 2 or Companion 2, unknown to them. Therefore we decided to check the compliance of type I diabetic adolescents and young adults with home blood glucose monitoring (HBGM) by comparing the blood glucose values noted in their log book and those retrieved by the Sensorlink and to evaluate an eventual subsequent effect both on compliance and glycated haemoglobin (HbA1c). The study was carried out in 60 insulin-dependent diabetes mellitus (IDDM) patients (33 women and 27 men) chosen according to two criteria: (1) the use of a Medisense Pen 2 or Companion 2; (2) autonomous self-monitoring of blood glucose, i.e. without parental supervision. They were aged 21.3 +/- 6.3 years with a diabetes duration of 11.6 +/- 7.0 years. HbA1c was measured by an HPLC method (N: 4.4-6.0%) before and after the first use of the Sensorlink and HBGM data of the log books were recorded. After the first use of the Sensorlink, the patients were warned of the retrieving data. The 60 patients were divided into two groups (same mean age and diabetes duration), according to the mean level of HbA1c before Sensorlink: < or = 7% (good control; n = 33); > 7% (insufficient control; n = 27). Cheating was unrelated to sex and occurred in 36 patients (60%; aged: 19.3 +/- 4.7 years), up to 100% in 13 of them (22%); five patients had no log book (8%; aged: 24.0 +/- 5.0 years); 19 patients (32%; aged 24.4 +/- 7.9 years) didn't cheat at all. After the use of the Sensorlink system, cheating dramatically decreased to zero. The effect of the Sensorlink system on improvement of HbA1c was statistically significant in the 27 patients with insufficient control before Sensorlink, since mean HbA1c level decreased from 8.0 +/- 0.9% to 7.5 +/- 1.1% (P < 0.05). In conclusion, non compliance with HBGM occurs in 2/3 of adolescents and young adults with IDDM. The Sensorlink system puts an end to this phenomenon and allows significant reduction of HbA1c levels in patients with insufficient metabolic control.
最近,美迪生公司推出了Sensorlink系统,作为一种工具,可用于获取患者毫不知情地存储在其第二代血糖仪(Pen 2)或第二代配套设备(Companion 2)中的最近125次家庭血糖监测结果。因此,我们决定通过比较I型糖尿病青少年和青年在其日志中记录的血糖值与通过Sensorlink系统获取的血糖值,来检查他们在家进行血糖监测(HBGM)的依从性,并评估这对依从性和糖化血红蛋白(HbA1c)最终产生的后续影响。该研究针对60名胰岛素依赖型糖尿病(IDDM)患者(33名女性和27名男性)开展,入选依据两条标准:(1)使用美迪生第二代血糖仪(Pen 2)或第二代配套设备(Companion 2);(2)自主进行血糖自我监测,即无需父母监督。他们的年龄为21.3±6.3岁,糖尿病病程为11.6±7.0年。在首次使用Sensorlink系统之前,采用高效液相色谱法(HPLC)测量糖化血红蛋白(HbA1c)(正常范围:4.4 - 6.0%),并记录日志中的HBGM数据。在首次使用Sensorlink系统后,告知患者数据已被获取。根据Sensorlink系统使用前糖化血红蛋白(HbA1c)的平均水平,将这60名患者分为两组(平均年龄和糖尿病病程相同):≤7%(控制良好;n = 33);>7%(控制不佳;n = 27)。存在作弊行为的情况与性别无关,36名患者(60%;年龄:19.3±4.7岁)有作弊行为,其中13名患者(22%)作弊率高达100%;5名患者没有日志(8%;年龄:24.0±5.0岁);19名患者(32%;年龄24.4±7.9岁)完全没有作弊。在使用Sensorlink系统后,作弊行为急剧减少至零。对于Sensorlink系统使用前控制不佳的27名患者,该系统对糖化血红蛋白(HbA1c)改善的效果具有统计学意义,因为糖化血红蛋白(HbA1c)的平均水平从8.0±0.9%降至7.5±1.1%(P < 0.05)。总之,三分之二的IDDM青少年和青年在家进行血糖监测时存在不依从情况。Sensorlink系统终结了这一现象,并使代谢控制不佳患者的糖化血红蛋白(HbA1c)水平显著降低。