实时动态血糖监测系统在不同时段检测的准确性变化特征及其与血糖波动的关系

目的 研究实时动态血糖监测系统(real-time continuous monitoring system,RT-CGMS)在不同时段检测的准确性及其与血糖波动的关系.方法 33例1型或2型糖尿病患者佩戴RT-CGMS5 d,每天测定7次毛细血管血糖值.应用相关分析、误差栅格分析(EGA)、Bland-Altman分析方法研究RT-CGMS在不同时段和总体水平与毛细血管血糖相关性、准确性和一致性;计算不同时段和总体水平的平均血糖波动幅度(MAGE)及血糖波动频率(FGE).结果 (1)RT-CGMS在空腹时段、餐后时段和总体水平与毛细血管血糖相关系数分别为0.94、0.92和0.93(均P＜0.01).(2)EGA显示,空腹时段、餐后时段和总体水平分别有98.82%、98.39%和98.64%的点落在A区和B区;1.18%、1.61%和1.36%的点在D区;没有点落在C区和E区.(3)RT-CGMS在空腹时段、餐后时段和总体水平与毛细血管血糖的一致性良好.(4)空腹时段、餐后时段和总体水平的MAGE分别为(3.57±2.66)、(4.07±3.09)和(4.02±3.04)mmol/L(P＞0.05);FGE分别为(0±0.5)、(3±1)和(1±3)次/d(P＜0.01).结论 RT-CGMS在空腹时段检测准确性高于餐后时段和总体水平;餐后时段血糖波动频率高于空腹时段和总体水平.

Abstract：

Objective To study the accuracy of real-time continuous monitoring system (RT-CGMS) at different stages and its association with glucose excursion. Methods Totally 33 patients with type 1 diabetes or type 2diabetes were under surveillance of RT-CGMS for 5 d. Capillary glucose values were measured 7 times daily.Correlation coefficient, error grid analysis (EGA), and Bland-Altman analysis methods were used to assess the correlation, accuracy and agreement of RT-CGMS at different stages and in general level; The mean amplitude of glucose excursion (MAGE) and the frequency of glucose excursion ( FGE ) were also calculated. Results ( 1 ) The correlation coefficient of RT-CGMS with capillary glucose values at fasting, postprandial stages, and in general level were 0.94,0.92, and 0.93 respectively( P＜0.01 ). (2) EGA showed that 98.82%, 98.39%, and 98.64% of the results fell in the A and B zones and 1. 18%, 1.61%, and 1.36% fell in the D zone respectively at fasting,postprandial stages, and in general level. There is no result fell in C and E zones. ( 3 ) The agreement analysis showed that RT-CGMS readings were in close agreement with capillary glucose values at fasting, postprandial periods, and in general level. (4)The MAGE at fasting, postprandial periods, and in general level were (3.57±2.66), (4.07±3.09), and (4. 02 ±3.04) mmol/L (P＞0. 05), (0±0. 5), (3± 1), and( 1 ±3) d for FGE (P＜0. 01 ).Conclusion RT-CGMS at fasting stage has higher accuracy than postprandial stage and general level, FGE at fasting stage is higher than postprandial stage and general level.

The accuracy of real-time continuous monitoring system at different stages and its association with glucose excursion

Objective To study the accuracy of real-time continuous monitoring system (RT-CGMS) at different stages and its association with glucose excursion. Methods Totally 33 patients with type 1 diabetes or type 2diabetes were under surveillance of RT-CGMS for 5 d. Capillary glucose values were measured 7 times daily.Correlation coefficient, error grid analysis (EGA), and Bland-Altman analysis methods were used to assess the correlation, accuracy and agreement of RT-CGMS at different stages and in general level; The mean amplitude of glucose excursion (MAGE) and the frequency of glucose excursion ( FGE ) were also calculated. Results ( 1 ) The correlation coefficient of RT-CGMS with capillary glucose values at fasting, postprandial stages, and in general level were 0.94,0.92, and 0.93 respectively( P＜0.01 ). (2) EGA showed that 98.82%, 98.39%, and 98.64% of the results fell in the A and B zones and 1. 18%, 1.61%, and 1.36% fell in the D zone respectively at fasting,postprandial stages, and in general level. There is no result fell in C and E zones. ( 3 ) The agreement analysis showed that RT-CGMS readings were in close agreement with capillary glucose values at fasting, postprandial periods, and in general level. (4)The MAGE at fasting, postprandial periods, and in general level were (3.57±2.66), (4.07±3.09), and (4. 02 ±3.04) mmol/L (P＞0. 05), (0±0. 5), (3± 1), and( 1 ±3) d for FGE (P＜0. 01 ).Conclusion RT-CGMS at fasting stage has higher accuracy than postprandial stage and general level, FGE at fasting stage is higher than postprandial stage and general level.