Flash glucose monitoring and glycemic control in type 1 diabetes with subcutaneous insulin infusion
Tóm tắt
To analyze the association between scan frequency and glycemic measures in continuous subcutaneous insulin infusion (CSII) treated type 1 diabetes (T1DM) adults. This retrospective study included 140 patients (> 18 years) with T1DM who used flash glucose monitoring (FGM). For each patient, we analyzed the Ambulatory Glucose Profile data over a period of 90 days. Data regarding glucose management indicator (GMI), time above, below and within range (TIR) and coefficient of variation (CV) were correlated with the number of daily scans. The effect of each additional test on glucose parameters was also evaluated. Users performed a mean of 8.6 ± 4.4 scans per day. There was an inverse correlation between scanning frequency and GMI (r = − 0.431, p < 0.001), CV (r = − 0.440, p < 0.001), time above and below range (r = − 0.446, p < 0.001 and r = − 0.200, p = 0.018, respectively). The number of daily scans correlated positively with TIR (r = 0.554, p < 0.001). For each additional scan per day, the mean GMI decreased 0.09% and TIR increased 1.60%. In patients with T1DM and CSII, higher rates of scanning correlated with improved glycemic markers, including reduced GMI and CV and increased TIR. For each test performed, there was a significant effect on the improvement of all glucose parameters.
Tài liệu tham khảo
The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Eng J Med 329:977–986. https://doi.org/10.1016/s0022-3476(94)70190-3
Nathan DM (2014) The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview. Diabetes Care 37:9–16. https://doi.org/10.2337/dc13-2112
Miller KM, Beck RW, Bergenstal RM et al (2013) Evidence of a strong association between frequency of self-monitoring of blood glucose and hemoglobin A1c levels in T1D exchange clinic registry participants. Diabetes Care 36:2009–2014. https://doi.org/10.2337/dc12-1770
Schutt M, Kern W, Krause U et al (2006) Is the frequency of self monitoring of blood glucose related to long-term metabolic control? Multicenter analysis including 24,500 patients from 191 centers in Germany and Austria. Exp Clin Endocrinol Diabetes 114:384–388. https://doi.org/10.1055/s-2006-924152
Rodbard D (2017) Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes Technol Ther 19:25–37. https://doi.org/10.1089/dia.2017.0035
Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group (2008) Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med 359: 1464–1476. https://doi.org/10.1056/NEJMoa0805017
Charleer S, Mathieu C, Nobels F et al (2018) Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life: a real-world study. J Clin Endocrinol Metab 103:1224–1232. https://doi.org/10.1210/jc.2017-02498
van Beers CAJ, DeVries JH, Kleijer SJ et al (2016) Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial. Lancet Diabetes Endocrinol 4:893–902. https://doi.org/10.1016/S2213-8587(16)30193-0
Nana M, Moore SL, Ang E et al (2019) Flash glucose monitoring: impact on markers of glycaemic control and patient-reported outcomes in individuals with type 1 diabetes mellitus in the real-world setting. Diabetes Res Clin Pract 157:107893. https://doi.org/10.1016/j.diabres.2019.107893
Charleer S, De Block C, Huffel LV et al (2020) Quality of life and glucose control after 1 year of nationwide reimbursement of intermittently scanned continuous glucose monitoring in adults living with type 1 diabetes (FUTURE): a prospective observational real-world cohort study. Diabetes Care 43:389–397. https://doi.org/10.2337/dc19-1610
Bolinder J, Antuna R, Geelhoed-Duijvestijn P et al (2016) Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet 388:2254–2263. https://doi.org/10.1016/S0140-6736(16)31535-5
Oskarsson P, Antuna R, Geelhoed-Duijvestijn P et al (2018) Impact of flash glucose monitoring on hypoglycaemia in adults with type 1 diabetes managed with multiple daily injection therapy: a pre-specified subgroup analysis of the IMPACT randomised controlled trial. Diabetologia 61:539–550. https://doi.org/10.1007/s00125-017-4527-5
Dunn TC, Xu Y, Hayter G et al (2018) Real-world flash glucose monitoring patterns and associations between self-monitoring frequency and glycaemic measures: a European analysis of over 60 million glucose tests. Diabetes Res Clin Pract 137:37–46. https://doi.org/10.1016/j.diabres.2017.12.015
Calliari LE, Krakauer M, Vianna AG et al (2020) Real-world flash glucose monitoring in Brazil: can sensors make a difference in diabetes management in developing countries? Diabetol Metab Syndr 12:3. https://doi.org/10.1186/s13098-019-0513-z
Battelino T, Danne T, Bergenstal RM et al (2019) Clinical targets for continuous glucose monitoring data interpretation: recommendations from the international consensus on time in range. Diabetes Care 42:1593–1603. https://doi.org/10.2337/dci19-0028
Danne T, Nimri R, Battelino T et al (2017) International consensus on use of continuous glucose monitoring. Diabetes Care 40:1631–1640. https://doi.org/10.2337/dc17-1600
Cardoso H, Carvalho D, Pape E et al (2018) National consensus in the use of the flash glucose monitoring system in Portugal. Rev Port Diabetes 13:143–153
Vigersky RA, McMahon C (2019) The relationship of hemoglobin a1c to time-in-range in patients with diabetes. Diabetes Technol Ther 21:81–85. https://doi.org/10.1089/dia.2018.0310
Moreno-Fernandez J, Pazos-Couselo M, González-Rodriguez M et al (2018) Clinical value of flash glucose monitoring in patients with type 1 diabetes treated with continuous subcutaneous insulin infusion. Endocrinol Diabetes Nutr 65:556–563. https://doi.org/10.1016/j.endinu.2018.04.003
Halbron M, Bourron O, Andreelli F et al (2019) Insulin pump combined with flash glucose monitoring: a therapeutic option to improve glycemic control in severely nonadherent patients with type 1 diabetes. Diabetes Technol Ther 21:409–412. https://doi.org/10.1089/dia.2019.0041
Breton MD, Patek SD, Lv D et al (2018) Continuous glucose monitoring and insulin informed advisory system with automated titration and dosing of insulin reduces glucose variability in type 1 diabetes mellitus. Diabetes Technol Ther 20:531–540. https://doi.org/10.1089/dia.2018.0079
Abraham SB, Arunachalam S, Zhong A et al (2021) Improved real-world glycemic control with continuous glucose monitoring system predictive alerts. J Diabetes Sci Technol 15:91–97. https://doi.org/10.1177/1932296819859334
Graham C (2017) Continuous glucose monitoring and global reimbursement: an update. Diabetes Technol Ther 19:60–66. https://doi.org/10.1089/dia.2017.0096
Oyagüez I, Merino-Torres JF, Brito M et al (2020) Cost analysis of the flash monitoring system (FreeStyle Libre 2) in adults with type 1 diabetes mellitus. BMJ Open Diabetes Res Care 8:e001330. https://doi.org/10.1136/bmjdrc-2020-001330