家用连续血糖监测和混合膳食耐量试验筛查CFRD的可重复性

IF 4.2 Q1 ENDOCRINOLOGY & METABOLISM Journal of Clinical and Translational Endocrinology Pub Date : 2023-09-01 DOI:10.1016/j.jcte.2023.100323
Katherine Kutney , Beth A. Kaminski , Terri Casey , MaryAnn O'Riordan , Rose Gubitosi-Klug
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摘要

囊性纤维化相关性糖尿病(CFRD)与胰岛素可修复的肺功能衰退相关,因此早期发现至关重要。连续血糖监测仪(CGM)已显示出筛查的希望,但不推荐临床实践指南。对于特定患者的CGM结果的可重复性知之甚少。方法20例非胰岛素治疗的CF成人和青少年患者在家中放置了一个CGM,并佩戴了两个14天的疗程。参与者在每14天的第5天进行混合膳食耐受试验(MMTT)。将CGM 1和CGM 2的血糖数据与公布的异常阈值进行比较:百分比时间>140 mg/dL≥4.5%,百分比时间>140 mg/dL≥17.5%,百分比时间>180 mg/dL≥3.4%。比较重复MMTT的血糖峰值和2小时血糖阈值:140 mg/dL、180 mg/dL和200 mg/dL。结果当≥4.5%时,20例受试者中有5例CGM 1和CGM 2结果不一致。在%的时间内,>140 mg/dL的>17.5%和>180 mg/dL的>3.4%, 20名受试者中只有1人的CGM 1和CGM 2的结果不一致。在MMTT试验中,很少有参与者2小时血糖达到140毫克/分升。峰值血糖为140mg /dL、180mg /dL和200mg /dL更常见,10-37%的参与者在CGM 1和CGM 2之间表现出不一致。结论在140mg /dL和180mg /dL这两个更严格的时间阈值下,重复的家庭CGM检测结果具有合理的重复性。在CFRD筛查中,需要更多的数据来确定异常混合膳食耐受性试验的阈值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Reproducibility of in-home CFRD screening using continuous glucose monitoring and mixed meal tolerance test

Background

Cystic fibrosis related diabetes (CFRD) is associated with insulin-remediable pulmonary decline, so early detection is critical. Continuous glucose monitors (CGM) have shown promise in screening but are not recommended by clinical practice guidelines. Little is known about the reproducibility of CGM results for a given patient.

Methods

Twenty non-insulin treated adults and adolescents with CF placed an in-home CGM and wore it for two 14-day periods. Participants underwent a mixed meal tolerance test (MMTT) on day 5 of each 14-day period. Glycemic data from CGM 1 and CGM 2 were compared regarding published thresholds to define abnormality: percent time >140 mg/dL of ≥4.5%, percent time >140 mg/dL of >17.5%, and percent time >180 mg/dL of >3.4%. Results of the repeat MMTT were compared for peak glucose and 2-hour glucose thresholds: >140 mg/dL, >180 mg/dL, and >200 mg/dL.

Results

For percent time >140 mg/dL of ≥ 4.5%, five of 20 subjects had conflicting results between CGM 1 and CGM 2. For percent time >140 mg/dL of >17.5% and >180 mg/dL of >3.4%, only one of 20 subjects had conflicting results between CGM 1 and CGM 2. On the MMTT, few participants had a 2-hour glucose >140 mg/dL. Peak glucose >140 mg/dL, 180 mg/dL, and 200 mg/dL were more common, with 10–37% of participants demonstrating disagreement between CGM 1 and CGM 2.

Conclusions

Repeated in-home CGM acquisitions show reasonable reproducibility regarding the more stringent thresholds for time >140 mg/dL and >180 mg/dL. More data is needed to determine thresholds for abnormal mixed meal tolerance tests in CFRD screening.

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CiteScore
6.10
自引率
0.00%
发文量
24
审稿时长
16 weeks
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