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在2型糖尿病患者中持续监测葡萄糖的频率和血糖控制
Irl B Hirsch1, Satish K Garg2, Enrico Repetto3
1University of Washington Medical School of Medicine, Seattle.
JAMA network open
|October 31, 2025
概括
在2型糖尿病中使用频繁的持续血糖监测 (CGM) 显著改善了血糖控制. 持续的传感器磨损,特别是超过75%,导致持续的血红蛋白A1C降低,与不经常或不使用CGM相比.
科学领域:
- 内分泌学和新陈代谢学
- 糖尿病管理 糖尿病管理
- 医疗信息学 医疗信息学
背景情况:
- 持续血糖监测 (CGM) 频率对2型糖尿病 (T2D) 的血糖控制的影响仍未得到充分研究.
- 了解这种关联对于优化糖尿病管理策略至关重要.
- 现有研究尚未完全阐明CGM使用和血糖结果之间的剂量反应关系.
研究的目的:
- 评估持续血糖监测 (CGM) 使用频率与12个月的血糖状况之间的关联.
- 为了比较T2D患者的血糖控制,CGM使用频率不同的人与没有使用CGM的人.
- 为了确定最佳的CGM使用模式,以改善血红蛋白A1C (HbA1C) 水平.
主要方法:
- 使用Optum无标识的市场清晰度数据 (2019-2023) 进行的回顾性,倾向分数匹配的横截面研究.
- 包括9258名T2D和基线HbA1C在7.0%-15.0%之间的成年患者.
- 分类CGM使用为四个频率 (≥1至≤90天,>90至≤180天,180至≤270天,>270天) 和对照组 (没有CGM使用) 超过12个月后索引.
- 主要结局:使用混合模型分析对HbA1C的变化.
主要成果:
- 高CGM使用 (>270天,频率4) 与12个月内最大的HbA1C降低 (-1.52个百分点) 与不使用CGM (-0.63个百分点) 相比.
- 在3个月内,在所有CGM频率组中观察到显著的HbA1C降低,在整个研究期间,在频率1和4组中观察到持续的改善.
- 在高CGM使用组中添加葡萄糖类-1受体激活剂进一步增强了HbA1C的降低 (与对照组的差异为-1.13个百分点).
结论:
- 频繁使用CGM (>75%的传感器磨损) 与2型糖尿病患者血糖控制的改善显著相关.
- 临床医生应在6个月后监测CGM的坚持,解决潜在的障碍,并鼓励持续使用CGM以获得持续的血糖益处.
- 研究结果支持将频繁使用CGM纳入T2D管理协议,以改善患者的治疗结果.
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