在患有1型糖尿病的成年人中使用糖尿病技术和视网膜病变
T Y Alvin Liu1, Julia Shpigel2, Fatima Khan2
1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
JAMA network open
|March 6, 2024
概括
在患有1型糖尿病的成年人中,持续血糖监测 (CGM) 的使用与发展糖尿病视网膜病变 (DR) 和糖尿病增殖视网膜病变 (PDR) 的几率降低有关. 这表明CGM可以帮助管理糖尿病和降低DR风险.
科学领域:
- 内分泌学 在内分泌学.
- 眼科医生 眼科 眼科
- 糖尿病 技术 技术
背景情况:
- 糖尿病视网膜病变 (DR) 是糖尿病患者视力丧失的主要原因.
- 持续血糖监测 (CGM) 和胰岛素使用对DR结果的影响仍然不清楚.
- 了解这些关联对于优化糖尿病管理和预防视力并发症至关重要.
研究的目的:
- 评估使用CGM,胰岛素或两者之间的关联,以及1型糖尿病 (T1D) 的成年人中DR和多发性糖尿病视网膜病变 (PDR) 的发生率.
主要方法:
- 从2013年到2021年,回顾性队列研究涉及550名患有T1D的成年人.
- 数据分析包括评估糖尿病技术 (CGM,胰岛素或两者) 的使用情况.
- 采用多变量后勤回归模型来确定技术使用与DR/PDR开发之间的关联,并根据关键临床因素进行调整.
主要成果:
- 与没有使用CGM相比,使用CGM与发展DR (OR,0.52;P=.008) 和PDR (OR,0.42;P=.004) 的几率明显较低.
- 胰岛素的使用和CGM和胰岛素的联合使用也显示了降低DR/PDR风险的趋势,尽管在多变量模型中并非所有都达到统计学意义.
- 大约44%的参与者在研究期间发展了DR.
结论:
- 持续血糖监测 (CGM) 的使用独立地与1型糖尿病成年人患糖尿病视网膜病变 (DR) 和糖尿病增殖视网膜病变 (PDR) 的风险降低有关.
- 这些发现凸显了CGM作为糖尿病管理战略中一个有价值的工具的潜力,旨在减轻DR的风险.
- 进一步的研究可以探索这种保护性关联背后的机制.
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