在CIRDIA（法国一家多站点院外中心）混合闭环系统启动前和启动后6个月血糖风险指数（GRI）和国际血糖指标

IF 4.6 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & metabolism Pub Date : 2025-02-06 DOI:10.1016/j.diabet.2025.101617

Sylvie Picard , Blandine Courbebaisse , Joëlle Dupont , Fabienne Amiot-Chapoutot , Emmanuelle Lecornet-Sokol , Estelle Personeni , François Mougel , Clara Bouché , Françoise Giroud , Sandrine Lablanche , Sophie Borot

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引用次数: 0

摘要

目的分析1型糖尿病（PwT1D）患者群体在混合闭环（HCL）开始后6个月的动态血糖谱（AGP）参数-包括血糖风险指数（GRI）。我们计算了达到血糖目标的人的百分比，并确定了可以识别达到目标的患者的GRI阈值。方法这是一项在CIRDIA进行的回顾性研究，CIRDIA是一个多站点（n=7）的院外HCL起始中心。在开始（M0）、3±1个月（M3）和6±1个月（M6）时，人工提取HCL平台前14天的AGP指标。如果时间范围为>，则认为PwT1D达到了疗效和安全性目标（EST）；70%， GMI为<；7%，时间低于范围（TBR）<70 %；4%, TBR<；54为<；1%。计算GRI并进行ROC分析，设定GRI阈值，以识别达到est的患者。结果136例患者获得6个月的数据。EST在M0、M3和M6时，PwT1D达到葡萄糖目标的比例分别为6.6%、40.4%和39.7%。GRI由56.0±20.9降至30.1±14.1和30.6±13.8。ROC分析显示，GRI值为GRI <；26是检测EST患者的最佳GRI值。该水平的阈值具有非常好的特异性（92%）和阴性预测值（93%），以确定那些确实需要进一步强化HCL支持的患者。结论将GRI阈值设为26，可以通过单个数字进行检测，CGM平台可能会自动计算出需要进一步支持的PwT1D。

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Glycemia Risk Index (GRI) and international glucose targets before and 6 months after initiation of hybrid closed loop system in the CIRDIA, a French multisite out-of-hospital center

Aims

To analyze in a population of persons with type 1 diabetes (PwT1D) ambulatory glucose profile (AGP) parameters – including glycemia risk index (GRI) – for six months after hybrid closed loop (HCL) initiation in a multisite out-of-hospital French center (CIRDIA). We calculated the percentage of people reaching glucose targets and determined a GRI threshold that could identify patients reaching targets.

Methods

This was a retrospective study conducted in the CIRDIA, a multisite (n=7) out-of-hospital HCL initiation center. AGP metrics for the 14 previous days were manually extracted from HCL platforms at initiation (M0), 3 ± 1 months (M3) and 6 ± 1 months (M6). PwT1D were considered as reaching efficacy and safety targets (EST) if time-in-range was > 70 %, GMI was < 7 %, time-below-range (TBR)^<70 was < 4 % and TBR^<54 was < 1 %. GRI was calculated and ROC analyses were performed to set a GRI threshold that could identify patients reaching EST.

Results

Six-month data were available for 136 persons. The percentage of PwT1D reaching glucose targets at respectively M0, M3 and M6 were for EST: 6.6 %, 40.4 % and 39.7 %. GRI decreased from 56.0 ± 20.9 to 30.1 ± 14.1 and 30.6 ± 13.8. ROC analyses showed that the best GRI value to detect patients who reached EST was GRI <26. A threshold set at this level had very good specificity (92 %) and negative predictive value (93 %) to identify those who do need further intensive support with HCL.

Conclusion

Setting a GRI threshold at 26 could be helpful to detect with a single number, potentially automatically calculated by CGM platforms, PwT1D who require further support.

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来源期刊

Diabetes & metabolism 医学-内分泌学与代谢

CiteScore

12.00

自引率

4.20%

发文量

审稿时长

13 days

期刊介绍： A high quality scientific journal with an international readership Official publication of the SFD, Diabetes & Metabolism, publishes high-quality papers by leading teams, forming a close link between hospital and research units. Diabetes & Metabolism is published in English language and is indexed in all major databases with its impact factor constantly progressing. Diabetes & Metabolism contains original articles, short reports and comprehensive reviews.