Can continuous glucose monitoring be used as a new tool for diagnosing white coat hyperglycaemia and possibly some other entities?

IF 0.3 Q3 MEDICINE, GENERAL & INTERNAL
M. Stojanović, Milica Pešić, S. Ilić, M. Deljanin-Ilić, V. Ćirić
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Abstract

Introduction. Since 1999 continuous glucose monitoring (CGM) has been used to measure the amount of glucose in the interstitial fluid. CGM is crucial when it comes to developing the ambulatory glucose profile and giving information on time spent in range (TIR), percentage of time spent above and below range, as well as variability. Discussion. It was in 1992 that Campbell et al. first described white coat hyperglycaemia, who explained it as patients having elevated blood glucose levels in a clinician's office or laboratory and normal glucose levels obtained by self-monitoring. Prior to the introduction of CGM, white coat hyperglycaemia was described as the discrepancy in the levels of office glucose and self-monitoring blood glucose (SMBG). Nowadays, it may be said that a patient has white coat hyperglycaemia when they have elevated office levels and normal SMBG levels or TIR above 70% on CGM. Recognising white coat hyperglycaemia is of crucial importance for treatment as its intensification based on office glycaemia alone can lead to episodes of hypoglycaemia and a potentially lethal outcome. Should comparison be made with arterial hypertension and ambulatory blood pressure monitoring (ABPM), CGM may provide several other options: 1) masked hyperglycaemia; 2) isolated nocturnal hyperglycaemia. Conclusion. It seems logical that CGM can be used for diagnosing white coat hyperglycaemia and possibly some (new) entities. Nonetheless, the clinical significance of all these entities can only be discussed after conducting adequately designed randomised clinical trials, which we would strongly encourage.
连续血糖监测能否作为诊断白大褂高血糖和其他疾病的新工具?
介绍。自1999年以来,连续血糖监测(CGM)已被用于测量间质液中的葡萄糖量。CGM在制定动态血糖谱和提供在范围内花费的时间(TIR)、在范围以上和以下花费的时间百分比以及可变性方面的信息时至关重要。讨论。1992年,Campbell等人首次对白大褂高血糖进行了描述,他们将其解释为患者在临床诊室或实验室中血糖水平升高,而通过自我监测获得的血糖水平正常。在引入CGM之前,白大褂高血糖被描述为办公室血糖和自我监测血糖(SMBG)水平的差异。如今,当办公室水平升高而SMBG水平正常或CGM的TIR高于70%时,可以说患者患有白大褂高血糖。识别白大褂高血糖对治疗至关重要,因为仅基于办公室血糖的白大褂高血糖加剧可导致低血糖发作和潜在的致命结果。如果与动脉高血压和动态血压监测(ABPM)进行比较,CGM可能提供其他几种选择:1)隐蔽性高血糖;2)孤立性夜间高血糖。结论。CGM可用于诊断白大褂高血糖和可能的一些(新)实体似乎是合乎逻辑的。尽管如此,所有这些实体的临床意义只有在进行充分设计的随机临床试验后才能讨论,我们强烈鼓励这样做。
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来源期刊
Acta Facultatis Medicae Naissensis
Acta Facultatis Medicae Naissensis MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
0.00%
发文量
13
审稿时长
12 weeks
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