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连续血糖监测系统的准确性和可靠性,重点关注低血糖症
Lukas van Baal1, Lorenz Raess1, Annie Mathew1
1Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
Diabetes, obesity & metabolism
|December 25, 2025
概括
持续血糖监测 (CGM) 的准确性在低血糖症中是可变的. 虽然CGM对于糖尿病患者和胰岛素瘤是可以接受的,但在胰岛素耐受性测试 (ITT) 中是不准确的.
科学领域:
- 内分泌学 在内分泌学.
- 医疗器械 医疗器械
- 临床诊断 临床诊断 临床诊断
背景情况:
- 持续血糖监测 (CGM) 广泛用于血糖管理.
- 关于CGM准确度的数据有限,特别是在低血糖范围内.
- 了解CGM在各种低血糖条件下的表现对于患者的安全至关重要.
研究的目的:
- 在不同的临床低血糖症环境中调查CGM系统的准确性.
- 在不同的葡萄糖变化率 (RoC) 中评估CGM性能.
- 在接受胰岛素耐受性测试 (ITT),胰岛素瘤患者和在胰岛素治疗中糖尿病患者中比较CGM准确度.
主要方法:
- 分析了92名患有低血糖症的人,来自三个不同的组:ITT (n=63),胰岛素瘤 (n=16) 和接受胰岛素治疗的糖尿病 (n=13).
- 使用平均绝对相对差异 (MARD),±20 mg/dL (%20/20),错误网格分析和布兰德-阿尔特曼分析 (BAA) 的百分比值来评估CGM的准确性.
- 基于子组和不同的葡萄糖ROC的CGM性能评估.
主要成果:
- 与糖尿病和胰岛素瘤组相比,CGM的准确性在各组之间有显著差异,在ITT组中MARD更高,ITT组的%20/20更低.
- 随着葡萄糖RoC的增加,CGM的准确性大幅下降.
- 没有检测到危险低血糖的CGM值中等风险的比例在ITT组 (14.2%) 中最高.
- 与糖尿病组相比,BAA表明ITT组的CGM读数偏差显著增加.
结论:
- 在所有临床低血糖情景中,CGM的准确性并不均.
- 在接受胰岛素治疗的糖尿病患者和胰岛素瘤患者中,CGM显示了可接受的准确性.
- 在胰岛素耐受性测试期间,CGM似乎对血糖监测不准确,这可能会带来潜在的风险.
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