扫描式葡萄糖监测在1型糖尿病患者随访管理中的应用  

Flash glucose monitoring system can reduce glucose volatility in patients with type 1 diabetes mellitus

作　　者：沈艳军[1] 王保华 李亮峰 李伟 田晓琴 卢绍霞 韩淑兰 田亚强[1] SHEN Yanjun;WANG Baohua;LI Liangfeng(Department of Endocrinology,Liaocheng People’s Hospital,Liaocheng 252000,China)

机构地区：[1]聊城市人民医院内分泌科,252000 [2]聊城市中心医院内分泌科 [3]聊城市国际和平医院内分泌科 [4]阳谷县第三人民医院内科 [5]雅培贸易(上海)有限公司糖尿病事业部

出　　处：《中国糖尿病杂志》2020年第11期838-841,共4页Chinese Journal of Diabetes

基　　金：山东省医药卫生科技发展计划项目(2015WS0392)。

摘　　要：目的评价扫描式葡萄糖监测(FGM)是否改善T1DM患者葡萄糖波动性。方法纳入聊城地区T1DM患者126例,随机分为FGM组(n=65)和自我血糖监测组(SMBG,n=61)。所有患者于第1、24、48周佩戴FGM传感器14 d,FGM组根据动态BG监测图谱进行饮食指导及Ins剂量调整,SMBG组根据空腹及3餐后2 h即时BG监测值进行调整。第50周采集葡萄糖波动水平(IQR)、目标范围内时间(TIR)、平均葡萄糖值(MBG)及低血糖持续时间终点数据进行统计。结果两组基线数值基本一致。24周时SMBG组TIR低于FGM组[(43.3±15.7)%vs(44.8±11.8)%,P<0.05],IQR、MBG及低血糖持续时间高于FGM组[(5.8±1.8)vs(5.2±1.3)mmol/L,(9.8±2.0)vs(9.5±1.2)mmol/L,(257.6±98.4)vs(232.5±72.5)min,P<0.05];48周时SMBG组TIR低于FGM组[(52.4±14.7)%vs(60.9±10.6)%,P<0.05],IQR、MBG及预估HbA1c均高于FGM组[(5.5±1.6)vs(4.7±1.0)mmol/L,(9.5±1.7)vs(8.7±1.2)mmol/L,(8.0±1.6)%vs(7.6±1.1)%,P<0.05]。结论FGM间断应用于T1DM管理,可有效降低BG波动幅度,增加目标范围内时间,减少低血糖发生风险。Objective To evaluate whether flash glucose monitoring(FGM)improves glucose vola⁃tility in patients with T1DM.Methods A total of 126 patients with T1DM who met the inclusion criteria were enrolled.They were randomly assigned to two groups:the FGM group(n=65)and the self⁃monitoring of blood glucose group(SMBG,n=61).All the patients wore FGM sensors for 14 days at the 1st,24 th and 48 th week,respectively.The dietary guidance and insulin dose adjustment was made in the patients in the FGM group according to the dynamic blood glucose monitoring map as well as the SMBG group accord⁃ing to the point of care testing(POCT)values under fasting and 2 h after three meals.The end point statis⁃tics at the 50 th week include:glucose interquartile range(IQR),time in range(TIR),mean blood glucose(MBG),and hypoglycemia duration.Results Baseline values of the two groups are basically consistent.At 24 week,TIR of SMBG group is lower than that in FGM group[(43.3±15.7)%vs(44.8±11.8)%,P<0.05],IQR,MBG and duration of hypoglycemia are higher than FGM group[(5.8±1.8)vs(5.2±1.3)mmol/L,(9.8±2.0)vs(9.5±1.2)mmol/L,(257.6±98.4)vs(232.5±72.5)min,P<0.05].At 48 week,TIR in SMBG group was lower than that in FGM group[(52.4±14.7)%vs(60.9±10.6)%,P<0.05],IQR,MBG and estimated HbA1c in SMBG group were higher than those in FGM group[(5.5±1.6)vs(4.7±1.0)mmol/L,(9.5±1.7)vs(8.7±1.2)mmol/L,(8.0±1.6)%vs(7.6±1.1)%,P<0.05].Conclusion The application of FGM discontinuation in T1DM can effectively reduce the interquartile range of blood glucose in patients,increase the time in range,reduce the risk of hypoglyce⁃mia.

关 键 词：扫描式葡萄糖监测 糖尿病 1型 葡萄糖波动性 

分 类 号：R587.1[医药卫生—内分泌]