持续葡萄糖监测对成人1型糖尿病患者血糖管理相关指标影响的Meta分析  

Meta-analysis of the effects of continuous glucose monitoring on blood glucose management-related indicators in adult patients with type 1 diabetes mellitus

作　　者：程爽 王莉[2] 陈玲雪 付阿丹[1] 易兰 汪娟 CHENG Shuang;WANG Li;CHEN Lingxue;FU Adan;YI Lan;WANG Juan(Nursing Department of the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China;Department of Endocrinology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院护理部,武汉430014 [2]华中科技大学同济医学院附属武汉中心医院内分泌科,武汉430014

出　　处：《中国临床新医学》2025年第2期217-225,共9页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：中华护理学会2021年立项科研课题(编号:ZHKY202105);湖北省自然科学基金项目(编号:2023AFC041)。

摘　　要：目的通过Meta分析评价持续葡萄糖监测(CGM)对成人1型糖尿病(T1DM)患者血糖管理相关指标的影响。方法使用计算机检索PubMed、Embase、Web of Science、the Cochrane Library、中国知网、万方数据知识服务平台、维普网中采用CGM干预成人T1DM患者的随机对照试验(RCTs)文献,检索时限为建库至2024年5月。应用RevMan 5.4和STATA 17.0统计软件进行数据分析。结果共纳入11篇文献,合计样本量为1319例。Meta分析结果显示,试验组糖化血红蛋白(HbA1c)水平低于对照组[MD(95%CI)=-0.18(-0.34~-0.02),P=0.03]。亚组分析结果显示,干预后,不同CGM类型及基线HbA1c水平的患者HbA1c水平比较差异无统计学意义(P>0.05),干预时长≥24周的患者HbA1c水平低于干预时长<24周的患者。试验组目标范围内时间(TIR)高于对照组[MD(95%CI)=6.33(3.29~9.37),P<0.01]。与对照组相比,CGM可显著改善成人T1DM患者CGM相关指标包括低于目标范围时间(TBR)、高于目标范围时间(TAR)、葡萄糖变异系数(CV)、葡萄糖标准差(SD)、低血糖风险系数(LBGI)、平均葡萄糖波动幅度(MAGE)(P<0.01)。两组糖尿病治疗满意度问卷(DTSQ)评分比较[MD(95%CI)=0.83(-2.44~4.10)]、Gold评分比较[MD(95%CI)=-0.36(-0.77~0.04)]、Clarke评分比较[MD(95%CI)=-0.16(-0.48~0.16)]、低血糖恐惧-忧虑量表(HFS-WS)评分比较[MD(95%CI)=0.34(-4.59~5.27)]差异均无统计学意义(P>0.05)。结论CGM可改善成人T1DM患者HbA1c水平和CGM相关指标,值得临床推广。Objective To systematically evaluate the effects of continuous glucose monitoring(CGM)on blood glucose management-related indicators in adult patients with type 1 diabetes mellitus(T1DM)by using meta-analysis.Methods Randomized controlled trials(RCTs)involving CGM intervention in adult patients with T1DM were searched by computer in the databases of PubMed,Embase,Web of Science,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform and VIP.The publication time of the searched papers was from the establishment of each database until May 2024.Data analysis was performed using RevMan 5.4 and STATA 17.0 statistical softwares.Results A total of 11 papers were included,with a total sample size of 1319 cases.The results of meta-analysis showed that the level of glycosylated hemoglobin A 1c(HbA 1c)in the trial group was lower than that in the control group[MD(95%CI)=-0.18(-0.34--0.02),P=0.03].The results of subgroup analysis showed that there were no significant differences in HbA 1c levels in patients with different CGM types and baseline HbA 1c levels after intervention(P>0.05),and the HbA 1c level in patients with intervention duration≥24 weeks was lower than that in patients with intervention duration<24 weeks.Time in range(TIR)in the trial group was higher than that in control group[MD(95%CI)=6.33(3.29-9.37),P<0.01].Compared with the control group,CGM could significantly improve the relevant indicators of CGM in adult patients with T1DM,including time below range(TBR),time above range(TAR),coefficient of variation(CV)of glucose,standard deviation(SD)of glucose,low blood glucose index(LBGI),and mean amplitude of glycemic excursion(MAGE)(P<0.01).There were no significant differences(P>0.05)in Diabetes Treatment Satisfaction Questionnaire(DTSQ)scores[MD(95%CI)=0.83(-2.44-4.10)],Gold scores[MD(95%CI)=-0.36(-0.77-0.04)],Clarke scores[MD(95%CI)=-0.16(-0.48-0.16)]and the scores of Hypoglycemia Fear Survey-Worry Scale(HFS-WS)[MD(95%CI)=0.34(-4.59-5.27)]between the two gr

关 键 词：持续葡萄糖监测 1型糖尿病 成人 糖化血红蛋白 目标范围内时间 

分 类 号：R587.1[医药卫生—内分泌]