摘要
目的评估1型糖尿病(T1DM)患儿使用扫描式葡萄糖监测系统(FGM)连续动态血糖监测的效果、成本和不良反应等情况。方法选择2016年5月至2018年2月在深圳市儿童医院就诊且使用FGM并有FGM下载数据的T1DM患儿7例,其中男3例,女4例;年龄9.3~16.3岁。回顾性分析其使用FGM前后4周的糖化血红蛋白(HbA1)、低血糖和高血糖的发生情况、自我血糖监测(SMBG)情况及费用,并记录FGM传感器有效植入时间和不良反应情况。结果使用FGM后HbA1c、高血糖和低血糖的发生率较使用前降低[(8.10±0.14)%比(8.86±0.32)%、(0.27±0.04)次/d比(0.62±0.05)次/d、(0.20±0.02)次/d比(0.37±0.05)次/d],差异均有统计学意义(t=2.727、9.291、2.908,P=0.034、0.001、0.027)。使用FGM后血糖监测频率[(11.09±0.96)次/d]显著高于使用前[(4.02±0.47)次/d],差异有统计学意义(t=-24.398,P=0.001)。使用FGM后血糖监测费用[(814.29±17.71)元]略高于使用前[(758.89±33.42)元],但差异无统计学意义(P>0.05)。使用FGM第1、7、13天时FGM扫描与SMBG测定的血糖值之间差异均无统计学意义(均P>0.05)。T1DM患者使用FGM期间,在不同血糖区间FGM扫描和SMBG测定的血糖值差异均无统计学意义(均P>0.05)。传感器有效植入时间(13.9±0.1) d,未发现不良反应,如皮肤过敏、瘙痒、红肿和感染现象。结论儿童T1DM使用FGM进行连续动态血糖监测安全性高、稳定可靠,对降低HbA1c、减少低血糖和高血糖发生、增加自我血糖监测频率等具有重要作用。
Objective To evaluate the usefulness, cost and side effects of flash glucose monitoring (FGM) in children with type 1 diabetes mellitus (T1DM). Methods Seven children aged 9.3-16.3 years old with T1DM (3 males, 4 females) treated with insulin in Shenzhen Children′s Hospital from May 2016 to February 2018 were enrolled, and they were performed with self-monitoring of blood glucose.All participants were subjected to FGM for 4 weeks and compared for changes in terms of hemoglobin A1c (HbA1c), episodes of hypoglycemia and hyperglycemia, frequency of self-monitoring blood glucose(SMBG) or sensor scanning, costs of glucose monitoring and side effects before and after 4-week implementation of FGM. Results The HbA1c was significantly reduced from (8.86±0.32)% before FGM to (8.10±0.14)% after implementation of FGM, and the difference was statistically significant (t=2.727, P=0.034). Both the frequency of hyperglycemia and hypoglycemia were significantly decreased after the implementation of FGM[(0.27±0.04) times/d vs.(0.62±0.05) times/d,(0.20±0.02) times/d vs.(0.37±0.05) times/d], and the differences were statistically significant(t=9.291, 2.908, P=0.001, 0.027). The average frequency of sensor scanning after the implementation of FGM was significantly higher than SMBG testing before use of FGM[(11.09±0.96) times/d vs.(4.02±0.47) times/d], and the difference was statistically significant(t=-24.398, P=0.001). The cost of FGM was a little higher than that of capillary blood glucose testing while there was no significant difference[(814.29±17.71) yuan vs.(758.89±33.42) yuan, P>0.05]. Comparing the results of the FGM and SMBG on the 1st, 7th and 13th day after FGM, there was no significant difference (all P>0.05). Also there was no significant diffe-rence among the different ranges of blood glucose (all P>0.05). The time with sensor of FGM in the arm was (13.9±0.1) days.There was no side effect to be found during 4 weeks of implementation of FGM. Conclusions FGM has the potential to increase the time of SMBG, dec
作者
赵岫
苏喆
王立
Zhao Xiu;Su Zhe;Wang Li(Department of Endocrinology, Shenzhen Children′s Hospital, Shenzhen 518000, Guangdong Province, China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2019年第8期587-590,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
深圳市科技计划项目(201203075).
关键词
扫描式葡萄糖监测系统
1型糖尿病
血糖
治疗
儿童
Flash glucose monitoring system
Type 1 diabetes mellitus
Glucose
Therapy
Child
