To Use or Not to Use a Self-monitoring of Blood Glucose System? Real-world Flash Glucose Monitoring Patterns Using a Cluster Analysis of the FGM-Japan Study
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- Sakane Naoki
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
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- Hirota Yushi
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
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- Yamamoto Akane
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
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- Miura Junnosuke
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Japan
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- Takaike Hiroko
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Japan
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- Hoshina Sari
- Diabetes Center, Tokyo Women's Medical University School of Medicine, Japan
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- Toyoda Masao
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Japan
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- Saito Nobumichi
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Japan
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- Hosoda Kiminori
- Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Japan
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- Matsubara Masaki
- Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Japan Department of General Medicine, Nara Medical University, Japan
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- Tone Atsuhito
- Department of Internal Medicine, Okayama Saiseikai General Hospital, Japan
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- Kawashima Satoshi
- Kanda Naika Clinic, Japan
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- Sawaki Hideaki
- Sawaki Internal Medicine and Diabetes Clinic, Japan
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- Matsuda Tomokazu
- Matsuda Diabetes Clinic, Japan
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- Domichi Masayuki
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
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- Suganuma Akiko
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
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- Sakane Seiko
- Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
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- Murata Takashi
- Department of Clinical Nutrition, National Hospital Organization Kyoto Medical Center, Japan Diabetes Center, National Hospital Organization Kyoto Medical Center, Japan
抄録
<p>Objective This study investigated self-monitoring of blood glucose (SMBG) adherence and flash glucose monitoring patterns using a cluster analysis in Japanese type 1 diabetes (T1D) patients with intermittently scanned continuous glucose monitoring (isCGM). </p><p>Methods We measured SMBG adherence and performed a data-driven cluster analysis using a hierarchical clustering in T1D patients from Japan using the FreeStyle Libre system. Clusters were based on three variables (testing glucose frequency and referred Libre data for hyperglycemia or hypoglycemia). </p><p>Patients We enrolled 209 participants. Inclusion criteria were patients with T1D, duration of isCGM use ≥3 months, age ≥20 years old, and regular attendance at the collaborating center. </p><p>Results The rate of good adherence to SMBG recommended by a doctor was 85.0%. We identified three clusters: cluster 1 (low SMBG test frequency but high reference to Libre data, 17.7%), cluster 2 (high SMBG test frequency but low reference to Libre data, 34.0%), and cluster 3 (high SMBG test frequency and high reference to Libra data, 48.3%). Compared with other clusters, individuals in cluster 1 were younger, those in cluster 2 had a shorter Libre duration, and individuals in cluster 3 had lower time-in-range, higher severe diabetic distress, and high intake of snacks and sweetened beverages. There were no marked differences in the incidence of diabetic complications and rate of wearing the Libre sensor among the clusters. </p><p>Conclusion We stratified the patients into three subgroups with varied clinical characteristics and CGM metrics. This new substratification might help tailor diabetes management of patients with T1D using isCGM. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 62 (18), 2607-2615, 2023-09-15
一般社団法人 日本内科学会