连续葡萄糖监测仪在对无症状 1 型糖尿病儿童进行分期时的辨别力和精确度。

IF 5 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Elisabeth Huber, Tarini Singh, Melanie Bunk, Mayscha Hebel, Kerstin Kick, Andreas Weiß, Mirjam Kohls, Melanie Köger, Maja Hergl, Jose Maria Zapardiel Gonzalo, Ezio Bonifacio, Anette-G Ziegler
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引用次数: 0

摘要

背景:无症状前1型糖尿病的分期和监测包括对血糖异常的评估:评估连续血糖监测(CGM)区分胰岛自身抗体阴性对照组和早期1型糖尿病的能力,并探讨CGM分类器是否能预测临床糖尿病的进展:邀请德国巴伐利亚州参加胰岛自身抗体公共卫生筛查的儿童和青少年使用 Dexcom G6 进行 CGM。共有 118 人参加,其中 97 人(57 名女性;年龄中位数为 10 [3-17] 岁)获得了有效数据,包括 46 名第一阶段患者、18 名第二阶段患者和 33 名无胰岛自身抗体患者:胰岛自身抗体阴性对照组在进行 CGM 时的平均血糖较高(中位数,115.3 mg/dl),且差异较大(IQR,106.8-124.4)。对照组中有 11 人(33%)超过 10% 的血糖值高于 140 mg/dl(TA140)。使用与对照组 100%特异性相对应的阈值,可得出对照组与 1 期和 2 期之间在葡萄糖标准偏差、TA140、TA160 和 TA180 方面的差异。其中任何两个参数升高都可确定 12 人(67%)为 2 期患者,11 名参与者中有 9 人(82%)在一年内发展为临床糖尿病。然而,所有参数在组内都存在明显差异,在对 18 名参与者进行的第二次 CGM 中观察到的一致性较差:这项研究证明了将 CGM 纳入早期 1 型糖尿病分期和监测的潜力。然而,要将 CGM 应用于常规监测实践,还需要大幅提高 CGM 的精确度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Discrimination and Precision of Continuous Glucose Monitoring in Staging Children With Presymptomatic Type 1 Diabetes.

Context: Staging and monitoring of presymptomatic type 1 diabetes includes the assessment for dysglycemia.

Objective: To assess the ability of continuous glucose monitoring (CGM) to differentiate between islet autoantibody-negative controls and early-stage type 1 diabetes and explore whether CGM classifiers predict progression to clinical diabetes.

Research design and methods: Children and adolescents participating in public health screening for islet autoantibodies in Bavaria, Germany, were invited to undergo CGM with Dexcom G6. In total, 118 participated and valid data was obtained from 97 [57 female; median age 10 (range 3-17) years], including 46 with stage 1, 18 with stage 2, and 33 with no islet autoantibodies.

Results: Mean glucose during CGM in islet autoantibody-negative controls was high (median, 115.3 mg/dL) and varied substantially (interquartile range, 106.8-124.4). Eleven (33%) of the controls had more than 10% of glucose values above 140 mg/dL (TA140). Using thresholds corresponding to 100% specificity in controls, differences between controls and stage 1 and stage 2 were obtained for glucose SD, TA140, TA160, and TA180. Elevations in any 2 of these parameters identified 12 (67%) with stage 2 and 9 (82%) of 11 participants who developed clinical diabetes within 1 year. However, there was marked variation within groups for all parameters and poor consistency observed in a second CGM performed in 18 participants.

Conclusion: This study demonstrated the potential of integrating CGM into staging and monitoring of early-stage type 1 diabetes. However, substantial improvement in the precision of CGM is required for its application in routine monitoring practices.

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来源期刊
Journal of Clinical Endocrinology & Metabolism
Journal of Clinical Endocrinology & Metabolism 医学-内分泌学与代谢
CiteScore
11.40
自引率
5.20%
发文量
673
审稿时长
1 months
期刊介绍: The Journal of Clinical Endocrinology & Metabolism is the world"s leading peer-reviewed journal for endocrine clinical research and cutting edge clinical practice reviews. Each issue provides the latest in-depth coverage of new developments enhancing our understanding, diagnosis and treatment of endocrine and metabolic disorders. Regular features of special interest to endocrine consultants include clinical trials, clinical reviews, clinical practice guidelines, case seminars, and controversies in clinical endocrinology, as well as original reports of the most important advances in patient-oriented endocrine and metabolic research. According to the latest Thomson Reuters Journal Citation Report, JCE&M articles were cited 64,185 times in 2008.
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