CDS 2015：Pozzilli教授：动态血糖监测(CGM)在2型糖尿病管理中的越受欢迎

2015-12-14 MedSci MedSci原创

意大利罗马生物医学院波齐利(Paolo Pozzilli) 在胰岛素治疗、血糖控制不良的2型糖尿病患者中，新技术的应用及价值一直存在争议。随机试验OpT2mise比较了胰岛素泵持续皮下注射(CSII)和每日多次皮下注射(MDI)对2型糖尿病患者血糖的影响，显示CSII较MDI显著改善患者血糖特征，并且不增加低血糖风险。近期几项将自我血糖监测(SMBG)整合进糖尿病护理的研究显

意大利罗马生物医学院波齐利(Paolo Pozzilli)

在胰岛素治疗、血糖控制不良的2型糖尿病患者中，新技术的应用及价值一直存在争议。随机试验OpT2mise比较了胰岛素泵持续皮下注射(CSII)和每日多次皮下注射(MDI)对2型糖尿病患者血糖的影响，显示CSII较MDI显著改善患者血糖特征，并且不增加低血糖风险。

近期几项将自我血糖监测(SMBG)整合进糖尿病护理的研究显示，患者平均血糖水平、血糖变异性、代谢性危险因素、抑郁症/糖尿病相关心理应激和健康行为都有所改善。前瞻性随机试验PRISMA探索强化自我监测血糖管理在非胰岛素治疗的2型糖尿病患者中的价值，是迄今为止有关SMBG 在2 型糖尿病患者中有效性的最大规模研究，其结果确认，在非胰岛素治疗的2型糖尿病患者中，使用结构性SMBG对于指导治疗处方和生活方式干预具有临床价值和整体安全性。

动态血糖监测(CGM)在2型糖尿病管理中的应用由于缺乏基于严格入选受试人群的临床试验以及强有力的循证依据而倍受争议。尽管许多研究通过不同指标对血糖变异性进行评估，CGM测量的平均血糖波动幅度(MAGE)仍被认为是量化血糖波动的最佳指标。报告显示，在胰岛素治疗的2型糖尿病患者中，实时CGM(RT-CGM)可以改善胰岛素波动。在12周内短期、间歇性地使用RT-CGM可有效改善血糖控制，并且不会增加低血糖风险。随访期间RT-CGM相对SMBG的有效性一直持续，并且不增加研究期间患者的药物使用强度。

总之，新技术在2型糖尿病患者管理中显示出有效性，也越来越受欢迎。

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#插入话题

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2016-08-10 zhishijing

#CGM#

50 0
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2016-05-03 wgsun

#动态血糖监测#

43 0
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2016-11-10 wodejia-dayu

#糖尿病管理#

57 0
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2015-12-26 hixiaoluo

好文章，值得看。

109 0
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2015-12-15 yangpeizhi

#CDS#

31 0
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2015-12-15 jktdtl

#血糖监测#

28 0
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2015-12-14 老段

动态监测，提高依从性

90 0

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