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インスリン治療を受けている1型または2型糖尿病患者の間歇的にスキャンされた継続的な血糖モニタリングの有効性: システマティックレビューとメタ解析
Mayra Souza Botelho1, Julia Simões Correa Galendi1, Mariana Andrades Fiorini Monteiro Novo1
1Department of Internal Medicine, Medical School, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil.
Diabetology & metabolic syndrome
|August 31, 2025
まとめ
断続的にスキャンされた継続的な血糖モニタリング (isCGM) は,糖尿病患者の自己モニタリングの血糖 (SMBG) と比較して,血糖制御と患者の満足度を改善します. isCGMはHbA1cと範囲下での時間を低下させますが,軽度の有害事象を増加させることがあります.
科学分野:
- 内分泌学
- 代謝 疾患
- 医療機器
背景:
- 効果的なグルコースモニタリングは,糖尿病の管理に不可欠です.
- 現在の方法には,自己モニタリング血糖 (SMBG),継続的な血糖モニタリング (CGM),間接的にスキャンされた継続的な血糖モニタリング (isCGM) が含まれる.
研究 の 目的:
- 1型または2型糖尿病患者のインスリン治療における isCGM と SMBG の有効性を評価する.
主な方法:
- 1型または2型糖尿病でインスリンを投与された4歳以上の患者を対象としたランダム化対照試験 (RCT) の系統的レビュー.
- 分析されたアウトカムには,HbA1c,範囲下での時間 (TBR),患者の満足度,有害事象,範囲内の時間 (TIR),低血糖症が含まれていた.
- メタアナリストはランダム効果モデルを使用して,GRADEシステムによって証拠の確実性を評価した.
主要な成果:
- isCGMの使用は,HbA1cの低下 (中等確実性) と患者の満足度の向上 (中等確実性) と関連していました.
- isCGMでTBRの低下 (低確実性) と,器具関連の軽度の有害事象の増加 (中等確実性) が観察されました.
- 範囲内の時間 (TIR) または低血糖エピソード (非常に低い確実性) に関する有意な効果は見つかりませんでした.
結論:
- isCGMは,HbA1cとTBRを低減し,インスリンを服用している糖尿病患者の満足度を高めることで,SMBGよりも利点があります.
- 潜在的な欠点は,軽度のデバイス関連の有害事象の発生率が高いことです.
- TIRと低血糖への影響については,さらなる調査が必要である.
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