[利用CGM控制血糖的有效性及未来展望]。

Daisuke Tsuriya, Masato Maekawa
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摘要

通过预防动脉硬化相关并发症如中风和心肌梗死的发生和发展来维持生活质量在糖尿病的治疗中是非常重要的。然而,最近的大型临床试验报告,通过使用胰岛素或口服降糖药来积极降低HbAlc水平会增加严重低血糖,导致心血管事件和死亡。糖尿病的治疗需要“高质量的血糖控制”,即改善餐后高血糖而不出现低血糖,使用连续血糖监测(CGM)确认24小时的血糖波动正引起人们的极大关注。CGM的引入有助于患者了解药物的效果,并更积极地进行治疗。此外,实时CGM提供了一个现场血糖值,从而实现严格的血糖控制。日本去年推出了传感器增强泵(SAP),患者可以实时确认自己的血糖水平,并及时调整胰岛素量。这样一种新的血糖监测系统正在出现。它不需要用穿刺针从指尖抽血,只需要将传感器连接到上臂外部,并将手持式读取器连接到传感器上,可以以每15分钟的频率提供累积数据,最长可达8小时。我们期望这种新设备能够实时提供血糖水平,以改善治疗。(审查)。
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[Usefulness of Glycemic Control Utilizing CGM and Future Prospects].

The maintenance of the QOL by preventing the onset and progression of arteriosclerosis-related complica- tions such as a stroke and myocardial infarction is very important in the treatment of diabetes. However, recent large clinical trials reported that aggressively reducing the HbAlc level by the use of insulin or oral antidiabetic agents increased severe hypoglycemia, resulting in cardiovascular events and deaths. A "good quality of glycemic control" that improves postprandial hyperglycemia without hypoglycemia is required for the treatment of diabetes, and confirmation of the fluctuations in blood glucose for 24 hours using CGM (continuous glucose-monitoring) is now attracting marked attention. The introduction of CGM is use- ful for the patient to understand the effect of drugs and get more motivated for the treatment. Furthermore, real-time CGM provides a value of blood glucose on the spot, resulting in strict glycemic control. A sensor- augmented pump (SAP) was released last year in Japan, and patients have been able to confirm their blood glucose level in real time and adjust the amount of insulin timely. Such a new glucose-monitoring system is emerging. It does not need the drawing of blood from the finger- tip by a puncture needle, requiring only the attachment of a sensor to the outside of the upper arm, and linking a hand-held reader to the sensor could provide cumulative data with a frequency of every 15 min for up to 8 h. We expect such new devices to provide the level of blood glucose in real time to improve therapy. [Review].

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