Glucose Monitoring Metrics in Individuals With Type 1 Diabetes Using Different Treatment Modalities: A Real-World Observational Study.

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes Care Pub Date : 2023-11-01 DOI:10.2337/dc23-1137
Kirsten Nørgaard, Ajenthen G Ranjan, Christian Laugesen, Katrine G Tidemand, Allan Green, Christian Selmer, Jannet Svensson, Henrik U Andersen, Dorte Vistisen, Bendix Carstensen
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Abstract

Objective: This study aimed to investigate the association between continuous glucose monitoring (CGM)-derived glycemic metrics and different insulin treatment modalities using real-world data.

Research design and methods: A cross-sectional study at Steno Diabetes Center Copenhagen, Denmark, included individuals with type 1 diabetes using CGM. Data from September 2021 to August 2022 were analyzed if CGM was used for at least 20% of a 4-week period. Individuals were divided into four groups: multiple daily injection (MDI) therapy, insulin pumps with unintegrated CGM (SUP), sensor-augmented pumps with low glucose management (SAP), and automated insulin delivery (AID). The MDI and SUP groups were further subdivided based on CGM alarm features. The primary outcome was percentage of time in range (TIR: 3.9-10.0 mmol/L) for each treatment group. Secondary outcomes included other glucose metrics and HbA1c.

Results: Out of 6,314 attendees, 3,184 CGM users were included in the analysis. Among them, 1,622 used MDI, 504 used SUP, 354 used SAP, and 561 used AID. Median TIR was 54.0% for MDI, 54.9% for SUP, 62,9% for SAP, and 72,1% for AID users. The proportion of individuals achieving all recommended glycemic targets (TIR >70%, time above range <25%, and time below range <4%) was significantly higher in SAP (odds ratio [OR] 2.4 [95% CI 1.6-3.5]) and AID (OR 9.4 [95% CI 6.7-13.0]) compared with MDI without alarm features.

Conclusions: AID appears superior to other insulin treatment modalities with CGM. Although bias may be present because of indications, AID should be considered the preferred choice for insulin pump therapy.

使用不同治疗方式的1型糖尿病患者的血糖监测指标:一项真实世界的观察研究。
目的:本研究旨在利用真实世界的数据研究连续血糖监测(CGM)衍生的血糖指标与不同胰岛素治疗模式之间的关系。研究设计和方法:丹麦哥本哈根Steno糖尿病中心的一项横断面研究,包括使用CGM的1型糖尿病患者。如果CGM在4周内至少使用了20%,则分析了2021年9月至2022年8月的数据。将个体分为四组:每日多次注射(MDI)治疗、具有非整合CGM的胰岛素泵(SUP)、具有低血糖管理的传感器增强泵(SAP)和自动胰岛素输送(AID)。MDI和SUP组根据CGM报警功能进一步细分。主要结果是每个治疗组在一定范围内的时间百分比(TIR:3.9-10.0 mmol/L)。次要结果包括其他血糖指标和HbA1c。结果:在6314名与会者中,3184名CGM用户被纳入分析。其中,1622人使用MDI,504人使用SUP,354人使用SAP,561人使用AID。MDI的中位TIR为54.0%,SUP为54.9%,SAP为62,9%,AID用户为72.1%。达到所有推荐血糖目标的个体比例(TIR>70%,时间高于范围结论:AID似乎优于CGM的其他胰岛素治疗模式。尽管由于适应症可能存在偏差,但AID应被视为胰岛素泵治疗的首选。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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