期刊
ARCHIVES OF ENDOCRINOLOGY METABOLISM
卷 67, 期 3, 页码 289-297出版社
SBEM-SOC BRASIL ENDOCRINOLOGIA & METABOLOGIA
DOI: 10.20945/2359-3997000000540
关键词
Flash glucose monitoring system; FreeStyle Libre; glycemic control; time in range; glycated hemoglobin; continuous glucose monitoring; hypoglycemia
This study evaluated the use of Flash glucose monitoring (FGM) compared to self-monitoring blood glucose (SMBG) in patients with type 1 diabetes. The results showed that FGM decreased the time spent in hypoglycemia and increased the time spent in hyperglycemia, but there was no significant change in the overall time in range.
Objectives: To evaluate the alternate use of flash glucose monitoring (FGM) with self-monitoring blood glucose (SMBG), in patients with type 1 diabetes (T1D). Materials and methods:Two weeks of open FGM (P2), both preceded (P1) and followed by 2 weeks (P3) of SMBG with a blinded FGM system. Mean absolute relative difference (MARD) was calculated by (|FGMi - SMBGi|) / SMBGi, where it was a paired data sample. Results: In total, 34 patients were evaluated. Time in range (TIR) did not change between P1 and P2. In 12 patients (35.3%), TIR increased from 40% at P1 to 52% at P2 (p = 0.002) and in 22 (64.7%), TIR decreased or did not change. FGM use resulted in decreased % time spent in hypoglycemia (<70 mg/dL) (6.5% vs. 5.0%; p = 0.005), increased % time spent in hyperglycemia (>180 mg/dL) (44.5% to 51%; p = 0.046) with no significant change in % TIR. The proportion of patients who reached sensor-estimated glycated hemoglobin (eA1c) < 7% decreased from 23.5% at P1 to 12.9% at P2, p = 0.028. For the whole sample, the MARD between the two methods was 15.5% (95% CI 14.5-16.6%). For normal glucose range, hyperglycemic levels and hypoglycemic levels MARD were 16.0% (95% CI 15.0-17.0%), 13.3% (95% CI 11.5-15.2%) and 23.4% [95% CI 20.5-26.3%)], respectively. Conclusion: FGM after usual SMBG decreased the % time spent in hypoglycemia concomitant with an undesired increase in % time spent in hyperglycemia. Lower accuracy of FGM regarding hypoglycemia levels could result in overcorrection of hypoglycemia. Arch Endocrinol Metab. 2023;67(3):289-97
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