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连续葡萄糖监测器上层检测极限以上的葡萄糖值的推算模型
Mikkel T Olsen1, Maria Panagiotou2,3, Knut J Strømmen2,3
1Steno Diabetes Center Copenhagen, Herlev, Denmark.
Diabetes technology & therapeutics
|May 21, 2025
概括
连续血糖监测器 (CGM) 有检测极限,可能会导致结果偏差. 一个新的统计模型准确地归因于高葡萄糖值,改善了患有高血糖症的患者的糖尿病管理.
科学领域:
- 内分泌学 在内分泌学.
- 生物统计学 生物统计学
- 医疗技术 医疗技术 医学技术
背景情况:
- 连续血糖监测器 (CGM) 对于糖尿病管理至关重要.
- CGMs具有上限检测极限 (通常为22.2 mmol/L),可以在葡萄糖指标中引入偏差.
- 精确评估血糖控制是必不可少的,特别是在严重高血糖的情况下.
研究的目的:
- 开发和验证一个统计模型,用于计算超出检测上限的连续血糖监测 (CGM) 值.
- 为了解决由检测上限引起的CGM指标的潜在偏差.
- 为了能够更准确地量化严重高血糖症患者的血糖控制.
主要方法:
- 采用贝叶斯的非参数潜伏高斯过程回归模型.
- 该模型应用于来自不同患者组的CGM数据:住院患者2型糖尿病患者和门诊患者1型和2型糖尿病患者.
- 数据有意在5%,10%,20%和30%的数据中进行了右侧审查,以模拟超出上限检测,并使用偏差,MSE和R2.2对未经审查的数据进行性能评估.
主要成果:
- 在所有患者组中,归算模型在各个审查级别中对平均葡萄糖,标准偏差 (SD) 和变化系数 (CV) 的偏差很低.
- 例如,对平均葡萄糖的偏差在各组和审查级别之间从-0.012到0.485不等.
- 平均平方误差 (MSE) 和确定系数 (R2) 也表明归算模型的表现良好,证实了它的准确性.
结论:
- 已成功开发和验证了高于检测上限的CGM葡萄糖值的可靠统计归算模型.
- 这种模型有效地纠正了由CGM的上检测极限引入的偏差.
- 经过验证的归算方法允许对血糖控制进行更准确,更公正的评估,对患有严重高血糖症的患者尤其有益.
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