Continuous Glucose Monitoring in Patients With Type 2 Diabetes Receiving Insulin Injections: Does This Mean Continuous Glucose Monitoring for Everyone?
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Editorials19 September 2017Continuous Glucose Monitoring in Patients With Type 2 Diabetes Receiving Insulin Injections: Does This Mean Continuous Glucose Monitoring for Everyone?Vanessa Arguello, MD and Matthew Freeby, MDVanessa Arguello, MDFrom David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.Search for more papers by this author and Matthew Freeby, MDFrom David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2121 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Despite advances in care over the past 2 decades, nearly half of persons living with type 2 diabetes mellitus (T2DM) have uncontrolled disease and are at high risk for complications (1). New technologies aimed at treatment, including advancements in glucose monitoring, may affect control and reduce hypoglycemia risk. Almost 3 decades has passed since the U.S. Food and Drug Administration approved the first continuous glucose monitoring (CGM) system. These devices, introduced in 1999, were uncomfortable, inaccurate, and difficult to use. Now, compact devices can provide consistent and timely data by measuring interstitial fluid every 5 minutes, correlating well with plasma ...References1. Ali MK, Bullard KM, Gregg EW. Achievement of goals in U.S. diabetes care, 1999–2010 [Letter]. N Engl J Med. 2013;369:287-8. [PMID: 23863067] doi:10.1056/NEJMc1306652 CrossrefMedlineGoogle Scholar2. Tamborlane WV, Beck RW, Bode BW, Buckingham B, Chase HP, Clemons R, et al; Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008;359:1464-76. [PMID: 18779236] doi:10.1056/NEJMoa0805017 CrossrefMedlineGoogle Scholar3. Battelino T, Conget I, Olsen B, Schütz-Fuhrmann I, Hommel E, Hoogma R, et al; SWITCH Study Group. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia. 2012;55:3155-62. [PMID: 22965294] doi:10.1007/s00125-012-2708-9 CrossrefMedlineGoogle Scholar4. Lind M, Polonsky W, Hirsch IB, Heise T, Bolinder J, Dahlqvist S, et al. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial. JAMA. 2017;317:379-387. [PMID: 28118454] doi:10.1001/jama.2016.19976 CrossrefMedlineGoogle Scholar5. Beck RW, Riddlesworth TD, Ruedy K, Ahmann A, Haller S, Kruger D, et al; DIAMOND Study Group. Continuous glucose monitoring versus usual care in patients with type 2 diabetes receiving multiple daily insulin injections. A randomized trial. Ann Intern Med. 2017;167:365-74. doi:10.7326/M16-2855 LinkGoogle Scholar6. Beck RW, Riddlesworth T, Ruedy K, Ahmann A, Bergenstal R, Haller S, et al; DIAMOND Study Group. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: the DIAMOND randomized clinical trial. JAMA. 2017;317:371-378. [PMID: 28118453] doi:10.1001/jama.2016.19975 CrossrefMedlineGoogle Scholar7. Vigersky RA, Fonda SJ, Chellappa M, Walker MS, Ehrhardt NM. Short- and long-term effects of real-time continuous glucose monitoring in patients with type 2 diabetes. Diabetes Care. 2012;35:32-8. [PMID: 22100963] doi:10.2337/dc11-1438 CrossrefMedlineGoogle Scholar8. Haak T, Hanaire H, Ajjan R, Hermanns N, Riveline JP, Rayman G. Flash glucose-sensing technology as a replacement for blood glucose monitoring for the management of insulin-treated type 2 diabetes: a multicenter, open-label randomized controlled trial. Diabetes Ther. 2017;8:55-73. [PMID: 28000140] doi:10.1007/s13300-016-0223-6 CrossrefMedlineGoogle Scholar9. Allen NA, Fain JA, Braun B, Chipkin SR. Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: a randomized clinical trial. Diabetes Res Clin Pract. 2008;80:371-9. [PMID: 18304674] doi:10.1016/j.diabres.2008.01.006 CrossrefMedlineGoogle Scholar10. Bailey TS, Grunberger G, Bode BW, Handelsman Y, Hirsch IB, Jovanovic L, et al; American Association of Clinical Endocrinologists (AACE). American Association of Clinical Endocrinologists and American College of Endocrinology 2016 outpatient glucose monitoring consensus statement. Endocr Pract. 2016;22:231-61. [PMID: 26848630] doi:10.4158/EP151124.CS CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2121.Corresponding Author: Vanessa Arguello, MD, David Geffen School of Medicine at UCLA, 1245 16th Street, Suite 307, Santa Monica, CA 90404; e-mail, [email protected]ucla.edu.Current Author Addresses: Dr. Arguello: David Geffen School of Medicine at UCLA, 1245 16th Street, Suite 307, Santa Monica, CA 90404.Dr. Freeby: David Geffen School of Medicine at UCLA, 200 Medical Plaza Driveway, Suite 530, Los Angeles, CA 90095.This article was published at Annals.org on 22 August 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoContinuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections Roy W. Beck , Tonya D. Riddlesworth , Katrina Ruedy , Andrew Ahmann , Stacie Haller , Davida Kruger , Janet B. McGill , William Polonsky , David Price , Stephen Aronoff , Ronnie Aronson , Elena Toschi , Craig Kollman , Richard Bergenstal , and Continuous Glucose Monitoring in Patients With Type 2 Diabetes Receiving Insulin Injections Robert A. Vigersky Metrics Cited byImpact of blinded retrospective continuous glucose monitoring on clinical decision making and glycemic control in persons with type 2 diabetes on insulin therapyContinuous Glucose Monitoring in Patients With Type 2 Diabetes Receiving Insulin InjectionsRobert A. Vigersky, MDStudies find novel approaches result in improved glycemic control in diabetes 19 September 2017Volume 167, Issue 6Page: 436-437KeywordsExerciseGlucoseHbA1cHyperglycemiaHypoglycemiaInsulinQuality of lifeType 1 diabetesType 2 diabetes ePublished: 22 August 2017 Issue Published: 19 September 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,025 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,003 | 0,002 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,004 |
| Science ouverte | 0,003 | 0,001 |
| Intégrité de la recherche | 0,006 | 0,012 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,012 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».