Continuous glucose monitoring defined time-in-range is associated with sudomotor dysfunction in type 2 diabetes

BACKGROUND Time in range(TIR),as a novel metric for glycemic control,has robust relevance with diabetic complications.Diabetic peripheral neuropathy(DPN)is characterized by sudomotor dysfunction.AIM To explore the relationship between TIR obtained from continuous glucose monitoring(CGM)and sudomotor function detected by SUDOSCAN in subjects with type 2 diabetes.METHODS The research enrolled 466 inpatients with type 2 diabetes.All subjects underwent 3-d CGM and SUDOSCAN.SUDOSCAN was assessed with electrochemical skin conductance in hands(HESC)and feet(FESC).Average feet ESC<60μS was defined as sudomotor dysfunction(+),otherwise it was sudomotor dysfunction(-).TIR refers to the percentage of time when blood glucose is between 3.9-10 mmol/L during 1 d period.RESULTS Among the enrolled subjects,135(28.97%)presented with sudomotor dysfunction.Patients with sudomotor dysfunction(+)showed a decreased level of TIR(P<0.001).Compared to the lowest tertile of TIR,the middle and the highest tertiles of TIR was associated with an obviously lower prevalence of sudomotor dysfunction(20.51%and 21.94%vs 44.52%)(P<0.001).In addition,with the increase of TIR,HESC and FESC increased(P<0.001).Regression analysis demonstrated that TIR was inversely and independently linked with the prevalence of sudomotor dysfunction after adjusting for confounding values(odds ratio=0.979,95%CI:0.971-0.987,P<0.001).CONCLUSION The tight glycemic control assessed by TIR is of vitally protective value for sudomotor dysfunction in type 2 diabetes mellitus.

Development of Wearable Semi-invasive Blood Sampling Devices for Continuous Glucose Monitoring: A Survey

Semi-invasive blood sampling devices mimic the way female mosquitoes extract blood from a host. They generally consist of a microneedle, a microactuator for needle insertion, a blood extraction mechanism and a blood glucose sensor. These devices have great potential to overcome the major disadvantages of several current blood glucose monitoring methods. Over last two decades, extensive research has been made in all of these related fields. More recently, several wearable devices for semi-invasive blood sampling have been developed. This review aims at summarizing the current state-of-the-art development and utilization of such wearable devices for continuous monitoring of blood glucose levels, with a special attention on design considerations, fabrication technologies and testing methods.

Review of minimally invasive continuous glucose monitoring technology & instruments

Continuous blood glucose monitoring is important for the diagnosis,treatment,and study of diabetes. many organizations have been working on this subject in recent two decades. Glucose concentration in interstitial fluid is closely related to the blood glucose levels. Minimally invasive continuous blood glucose monitoring technology based on the glucose detection in interstitial fluid develops rapidly and gets more and more attentions from the patients and the doctors,due to its instantaneous real-time display of glucose level,"24/7"coverage,and the ability to characterize glycemic variability. According to the different detection methods,most of the continuous glucose monitoring technology could be divided into two kinds: subcutaneous implantation method and transdermal extraction method. This paper review s the recent development of minimally invasive blood glucose monitoring technology and instruments. The mainly remained challenges and related research directions are presented as well.

What,why and how to monitor blood glucose in critically ill patients

Critically ill patients are prone to high glycemic variations irrespective of their diabetes status.This mandates frequent blood glucose(BG)monitoring and regulation of insulin therapy.Even though the most commonly employed capillary BG monitoring is convenient and rapid,it is inaccurate and prone to high bias,overestimating BG levels in critically ill patients.The targets for BG levels have also varied in the past few years ranging from tight glucose control to a more liberal approach.Each of these has its own fallacies,while tight control increases risk of hypoglycemia,liberal BG targets make the patients prone to hyperglycemia.Moreover,the recent evidence suggests that BG indices,such as glycemic variability and time in target range,may also affect patient outcomes.In this review,we highlight the nuances associated with BG monitoring,including the various indices required to be monitored,BG targets and recent advances in BG monitoring in critically ill patients.

Relationship between hemoglobin glycation index and risk of hypoglycemia in type 2 diabetes with time-in-range in target

BACKGROUND In patients with type 2 diabetes mellitus(T2DM),the risk of hypoglycemia also occurs in at a time-in-range(TIR)of>70%.The hemoglobin glycation index(HGI)is considered the best single factor for predicting hypoglycemia,and offers new perspectives for the individualized treatment of patients with well-controlled blood glucose levels that are easily ignored in clinical settings.All participants underwent a 7-days continuous glucose monitoring(CGM)using a retrospective CGM system.We obtained glycemic variability indices using the CGM system.We defined HGI as laboratory hemoglobin A1c minus the glucose management indicator.Patients were categorized into low HGI(HGI<0.5)and high HGI groups(HGI≥0.5)according to HGI median(0.5).Logistic regression and receiver operating characteristic curve analyses were used to determine the risk factors for hypoglycemia.RESULTS We included 129 subjects with T2DM(54.84±12.56 years,46%male)in the study.Median TIR score was 90%.The high HGI group exhibited lower TIR and greater time below range with higher hemoglobin A1c than the low HGI group;this suggests more glycemic excursions and an increased incidence of hypoglycemia in the high HGI group.Multivariate analyses revealed that mean blood glucose,standard deviation of blood glucose and HGI were independent risk factors for hypoglycemia.Receiver operating characteristic curve analysis indicated that the HGI was the best predictor of hypoglycemia.In addition,the optimal cut-off points for HGI,mean blood glucose,and standard deviation of blood glucose in predicting hypoglycemia were 0.5%,7.2 mmol/L and 1.4 mmol/L respectively.CONCLUSION High HGI was significantly associated with greater glycemic excursions and increased hypoglycemia in patients with TIR>70%.Our findings indicate that HGI is a reliable predictor of hypoglycemia in this population.

Evaluation of hybrid closed-loop insulin delivery system in type 1 diabetes in real-world clinical practice:One-year observational study

BACKGROUND In 2016,the Food and Drug Administration approved the first hybrid closed-loop(HCL)insulin delivery system for adults with type 1 diabetes(T1D).There is limited information on the impact of using HCL systems on patient-reported outcomes(PROs)in patients with T1D in real-world clinical practice.In this independent study,we evaluated glycemic parameters and PROs over one year of continuous use of Medtronic’s 670G HCL in real-world clinical practice.AIM To assess the effects of hybrid closed loop system on glycemic control and quality of life in adults with T1D.METHODS We evaluated 71 patients with T1D(mean age:45.5±12.1 years;59%females;body weight:83.8±18.7 kg,body mass index:28.7±5.6 kg/m2,A1C:7.6%±0.8%)who were treated with HCL at Joslin Clinic from 2017 to 2019.We measured A1C and percent of glucose time-in-range(%TIR)at baseline and 12 months.We measured percent time in auto mode(%TiAM)for the last two weeks preceding the final visit and assessed PROs through several validated quality-of-life surveys related to general health and diabetes management.RESULTS At 12 mo,A1C decreased by 0.3%±0.1%(P=0.001)and%TIR increased by 8.1%±2.5%(P=0.002).The average%TiAM was only 64.3%±32.8%and was not associated with A1C,%TIR or PROs.PROs,provided at baseline and at the end of the study,showed that the physical functioning submodule of 36Item Short-Form Health Survey increased significantly by 22.9%(P<0.001).Hypoglycemia fear survey/worry scale decreased significantly by 24.9%(P<0.000);Problem Areas In Diabetes reduced significantly by-17.2%(P=0.002).The emotional burden submodules of dietary diversity score reduced significantly by-44.7%(P=0.001).Furthermore,analysis of Clarke questionnaire showed no increase in awareness of hypoglycemic episodes.WHO-5 showed no improvements in subject’s wellbeing among participants after starting the 670G HCL system.Finally,analysis of Pittsburgh Sleep Quality Index showed no difference in sleep quality,sleep latency,or duration of sleep from baseline to 12 mo.CONCLUSION The use of HCL in real-world clinical practice for one year was associated with significant improvements in A1C,%TIR,physical functioning,hypoglycemia fear,emotional distress,and emotional burden related to diabetes management.However,these changes were not associated with time in auto mode.

Decreasing complexity of glucose time series derived from continuous glucose monitoring is correlated with deteriorating glucose regulation

Most information used to evaluate diabetic statuses is collected at a special time-point,such as taking fasting plasma glucose test and providing a limited view of individual’s health and disease risk.As a new parameter for continuously evaluating personal clinical statuses,the newly developed technique“continuous glucose monitoring”(CGM)can characterize glucose dynamics.By calculating the complexity of glucose time series index(CGI)with refined composite multi-scale entropy analysis of the CGM data,the study showed for the first time that the complexity of glucose time series in subjects decreased gradually from normal glucose tolerance to impaired glucose regulation and then to type 2 diabetes(P for trend<0.01).Furthermore,CGI was significantly associated with various parameters such as insulin sensitivity/secretion(all P<0.01),and multiple linear stepwise regression showed that the disposition index,which reflectsβ-cell function after adjusting for insulin sensitivity,was the only independent factor correlated with CGI(P<0.01).Our findings indicate that the CGI derived from the CGM data may serve as a novel marker to evaluate glucose homeostasis.

Continuous Glucose Monitoring in the Patients with Diabetic Nephropathy

The aim of this study was to compare the difference of blood glucose(BG) fluctuation in the patients of type-2 diabetes mellitus(DM-2) with and without clinical diagnosed diabetic nephropathy(DN) by the continuous glucose monitoring system(CGMS).Thirty DM-2 patients with clinical diagnosed DN and fifteen DM-2 patients without complication underwent continuous glucose monitoring for 3 days(72 h) by CGMS.The difference of daily glucose fluctuation in both groups was compared by the parameter of CGMS.The 24-h mean blood glucose (MBG),minimal BG(MIN-BG),area under curve of BG over 7.8(AUC7.8),percentage of time of BG over 7.8 (PT7.8),area under curve of BG over 11.1(AUC11.1),percentage of time of BG over 11.1(PT11.1),as well as mean of daily difference(MODD) were significantly increased in the group of DN,compared with those in the group of DM-2 without complication(all statistic probability P<0.05).No statistical significance of mean amplitude of glycaemic excursion(MAGE) was found.In the group of DN,MBG,standard deviation of blood glucose(SDBG),large amplitude of glycaemic excursion(LAGE),AUC7.8,PT7.8,AUC11.1,PT11.1,MAGE and MODD were(10.7±1.9) mmol/L,(2.5±1.3) mmol/L,(9.2±3.9) mmol/L,3.2±1.7,(81±18)%,1.2±1.0,(42±24)%, (5.8±2.5) mmol/L and(2.6±1.5) mmol/L,respectively.The study showed that the BG level of the patients with DN fluctuated throughout the day.MBG of the patients with DN was higher than that of the patients of DM-2 without complications,with the characteristics of long-lasting high BG period,dramatic instability during the day and especially high postprandial blood glucose.CGMS is a useful tool for physicians to know the details of the change of BG in the patients with DN.

Time in range as a useful marker for evaluating retinal functional changes in diabetic retinopathy patients

·AIM:To elucidate the relationship between macular sensitivity and time in range(TIR)obtained from continuous glucose monitoring(CGM)measures in diabetic patients with or without diabetic retinopathy(DR).·METHODS:This was a cross-sectional study including 100 eyes of non-DR patients and 60 eyes of DR patients.An advanced microperimetry was used to quantitate the retinal mean sensitivity(MS)and fixation stability in central macula.TIR of 3.9-10.0 mmol/L was evaluated with CGM.Pearson coefficient analysis and multiple linear regression analysis were used to assess the correlation between TIR and retinal sensitivity.·RESULTS:In a comparison of non-DR patients,significant differences(P<0.05)were found in Hb A1c,TIR,coefficient of variation(CV),standard deviation of blood glucose(SDBG)and mean amplitude of glucose excursion(MAGE)values in DR patients.Besides,those DR patients had significantly poor best-corrected visual acuity(BCVA,log MAR,P=0.001).In terms of microperimetry parameters,retinal mean sensitivity(MS)and the percentages of fixation points located within 2°and 4°diameter circles were significantly decreased in the DR group(P<0.001,P<0.001,P=0.02,respectively).The bivariate contour ellipse area(BCEA)encompassing 68.2%,95.4%,99.6%of fixation points were all significantly increased in the DR group(P=0.01,P=0.006,P=0.01,respectively).Correlation analysis showed that MS were significantly correlated with Hb A1c(P=0.01).TIR was positively correlated with MS(r=0.23,P=0.01).SDBG was negatively correlated with MS(r=-0.24,P=0.01)but there was no correlation between CV and MAGE with MS(P>0.05).A multivariable linear regression analysis was performed to prove that TIR and SDBG were both independent risk factors for MS reduction in the DR group.·CONCLUSION:TIR is correlated with retinal MS reduction in DR patients,suggesting a useful option for evaluating DR progression.

持续血糖监测评估的目标范围内时间与老年2型糖尿病患者蛋白尿的相关性研究

目的探讨老年2型糖尿病(T2DM)患者目标范围内时间(TIR)与糖尿病蛋白尿的关系。方法回顾性分析2016年10月—2020年8月上海市第八人民医院住院的176例老年T2DM患者临床资料。按患者的尿微量蛋白/尿肌酐比值分为正常蛋白尿组(n=99)、微量蛋白尿组(n=51)和大量蛋白尿组(n=26),比较3组一般资料及持续血糖监测指标。Spearman相关系数分析及多元序回归分析TIR四分位数与糖尿病蛋白尿严重程度的相关性。结果3组间性别、T2DM病程、高血压构成比、吸烟史、胰岛素使用、血管紧张素转换酶抑制剂及血管紧张素II受体阻滞剂使用、他汀类药物使用、收缩压、总胆固醇、低密度脂蛋白胆固醇、估算肾小球滤过率、平均血糖波动幅度、TIR及糖尿病视网膜病变患病率差异有统计学意义(P<0.05)。TIR四分位数与蛋白尿严重程度呈负相关(r=-0.407,P<0.001)。TIR越高,老年T2DM患者发生蛋白尿风险降低。结论TIR可能与老年T2DM患者蛋白尿的发病风险及严重程度有关。

术后早期连续血糖监测与取栓后急性缺血性卒中患者预后评估的相关性研究

目的 探讨急性缺血性卒中患者机械取栓术后1~7 d连续血糖水平与预后的相关性。方法 回顾性选取首都医科大学附属北京朝阳医院2021年1月1日至2023年8月31日期间接受机械取栓手术的151例急性缺血性卒中患者为研究对象,收集术后1~7 d空腹及早、午、晚餐后2 h的指尖血糖数据。出院后随访患者术后90 d改良Rankin评分(mRS),采用双变量相关性分析法研究术后1~7 d血糖水平与患者预后的相关性。结果 患者术后第1天(空腹,P=0.028)、第2天(午餐后,P=0.027)、第4天(早餐后,P=0.014)、第5天(午餐后,P=0.006)及第6天(早餐后,P=0.043)血糖水平与术后90 d mRS评分存在显著相关性。结论 术后1~7 d血糖控制对患者预后恢复有显著影响,高血糖状态与术后90 d较差的神经功能障碍显著相关。有效的血糖管理策略可以为患者提供更有利的康复条件和改善预后的可能性。

老年男性2型糖尿病患者血糖波动与骨代谢指标及骨密度的相关性研究

目的探讨老年男性2型糖尿病患者(T2DM)血糖波动相关指标与骨代谢指标及骨密度的相关性。方法选取2020年9月至2023年3月在安徽医科大学第一附属医院内分泌科就诊的老年男性T2DM患者252例,根据患者骨密度结果分为正常组、骨量减少组以及骨质疏松组。所有受试者均进行临床信息的采集,同时行体格检查、实验室检查,所有受试者均进行连续72h动态血糖监测(CGM),并收集血糖波动相关指标。采用t检验或方差检验对3组患者间的一般临床资料、实验室结果进行比较;采用Pearson相关分析、多元回归分析探讨血糖波动相关指标与骨代谢指标及骨密度的相关性。结果随着骨量减少的严重程度的增加,患者的年龄、病史时间显著增加,BMI显著降低,使用GLP-1受体激动剂的患者比例在骨质疏松症组显著减少。同时骨形成指标OC、PINP以及骨吸收指标CTX、TRAP均有明显减少。血糖波动指标TIR、SDBG、CV、MAGE、MODD随着患者骨量减少的严重程度的增加而显著增加。另外,通过Pearson相关分析、多元回归分析后发现,OC与CV、MAGE、MODD呈显著独立负相关,CTX与TIR、CV、MAGE呈显著独立负相关,TRAP与MAGE呈显著独立负相关。股骨颈T值与全髋T值与MAGE呈显著独立负相关。结论本研究发现老年男性T2DM患者血糖波动和骨转换标志物、骨密度之间存在独立的负相关关系。故积极控制老年男型T2DM患者的血糖波动可能有利于骨代谢以及骨密度的改善。

基于动态血糖监测结果评价门诊教育对2型糖尿病患者血糖谱的影响研究

背景 动态血糖监测(CGM)在门诊患者治疗中应用较少,基于CGM进行糖尿病教育,改变不良的生活、饮食习惯对血糖谱的影响尚不清楚。目的 基于回顾性CGM结果,对使用口服降糖药的门诊2型糖尿病(T2DM)患者进行饮食、运动等门诊教育,评价其对患者血糖谱的影响。方法 选取2021于南京市第一医院内分泌科门诊就诊使用口服降糖药的T2DM患者88例,其中男60例、女28例,给予CGM。入组患者给予门诊教育,即第1~3天维持原降糖治疗方案及生活习惯;第4天下载并分析CGM数据,结合患者饮食、运动等门诊教育,第6天取下CGM传感器和记录器,下载数据。比较第2天和第5天动态血糖数据[24 h平均血糖(MBG),平均血糖波动幅度(MAGE),葡萄糖目标范围内时间(TIR)]。结果 基于CGM结果,给予门诊教育后(第5天)T2DM患者的MBG由(8.34±1.97)mmol/L下降到(7.85±1.65)mmol/L,TIR由(78.21±24.64)%上升到(84.28±21.87)%,MAGE由(4.53±2.25)mmol/L下降到(3.80±1.80)mmol/L(P<0.05)。按糖尿病病程、年龄进行分层分析:病程<10年组(62例)和病程≥10年组(26例)干预后MBG均较干预前降低,干预后病程<10年组标准差(SD)、MAGE、TAR较干预前降低,TIR较干预前升高(P<0.05);按年龄分为<65岁组(55例)和≥65岁组(33例),两组干预后MBG、TAR较干预前降低,TIR较干预前升高,干预后<65岁组SD、MAGE较干预前降低(P<0.05)。结论 基于CGM结果,对使用口服降糖药物的门诊T2DM患者进行饮食、运动等门诊教育,可以有效改善患者MBG、提高TIR水平,改善血糖变异度;<65岁、糖尿病病程<10年的患者获益更大。

T2DM患者双下肢血管病变的影响因素研究

目的探究2型糖尿病(type 2 diabetes mellitus,T2DM)患者双下肢血管病变(lower extremity angiopathy,LEAD)的影响因素。方法回顾性选取2023年6月—2024年6月于四平市中心人民医院就诊的60例T2DM患者的临床资料,按照是否存在LEAD分为发生组(n=15)、未发生组(n=45),收集两组患者基本资料并通过Logistic回归分析LEAD发生的影响因素。结果两组糖尿病病程、年龄、血糖标准差、葡萄糖目标范围内时间、收缩压、平均血糖比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,年龄、糖尿病病程、收缩压、血糖标准差、平均血糖、葡萄糖目标范围内时间均为LEAD的影响因素(P均<0.05)。结论T2DM患者LEAD的影响因素包括年龄、收缩压、糖尿病病程、血糖标准差、平均血糖水平和葡萄糖目标范围内时间。

糖尿病血糖管理技术在老年糖尿病患者中的应用进展

综述糖尿病技术的发展及在老年糖尿病患者血糖管理的应用现状,包括连续血糖监测仪,持续皮下胰岛素输注,混合闭环等方面,并提出糖尿病技术在老年糖尿病患者应用中的挑战及发展建议,以期提高老年糖尿病患者低血糖和高血糖管理能力体系建设。

连续血糖监测在糖尿病血液透析患者中的应用

血液透析是终末期糖尿病肾病患者的重要治疗措施之一。血液透析治疗的糖尿病患者存在明显的血糖波动,维持血糖平稳是改善患者预后的重要策略之一。常规的血糖检测方法(如自我血糖监测、糖化血红蛋白、糖化白蛋白)具有一定的局限性,连续血糖监测系统将血糖波动可视化,有利于指导治疗及改善患者预后。

持续葡萄糖监测技术在糖尿病患者中的应用

目的:探究持续葡萄糖监测技术在糖尿病患者中的应用。方法:回顾性分析2023年1—12月六盘水市人民医院内分泌科住院及门诊就诊的180例糖尿病患者的临床资料。根据血糖监测方法的不同将其分为对照组和观察组,各90例。对照组实施指尖血糖监测,观察组实施持续葡萄糖监测技术。比较两组血糖水平,血糖达标情况,血糖波动情况,胰岛素用量,低血糖情况。结果:观察组午餐、晚餐前后血糖值均低于对照组,差异有统计学意义(P<0.05)。观察组平均血糖值低于对照组,血糖在目标范围内的时间(TIR)高于对照组,差异有统计学意义(P<0.05)。两组最大血糖波动幅度(LAGE)比较,差异无统计学意义(P>0.05);观察组四分位区间(IQR)、十分位数区间(IDR)均小于对照组,差异有统计学意义(P<0.05)。观察组日均胰岛素用量明显少于对照组,差异有统计学意义(t=4.849,P<0.001)。观察组低血糖发生率为18.89%,低于对照组的42.22%,差异有统计学意义(P<0.05)。结论:糖尿病患者实施持续葡萄糖监测的效果优于指尖血糖监测,血糖波动减少,胰岛素用量降低。

CGM技术监测2型糖尿病患者血糖波动幅度与SMBG血糖波动指标的相关性研究

目的:研究2型糖尿病患者持续葡萄糖监测(CGM)技术监测血糖波动幅度与自我血糖监测(SMBG)血糖波动指标的相关性。方法:选取我院2022年6月至2023年6月收治的82例2型糖尿病患者进行研究。所有患者均接受7个时间点(三餐前、餐后2 h以及睡前)的SMBG和48~72 h的CGM,同时根据7个时间点SMBG数据计算血糖变异系数(CV)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE1,SMBG计算得出)、血糖水平的标准差(SDBG)、餐后血糖波动幅度(PPGE)等血糖波动指标,采用简单线性回归分析法、Spearman秩相关分析法、多元逐步回归分析法,分析通过CGM获得的MAGE与通过SMBG计算得出的CV、LAGE、MAGE1、SDBG、PPGE之间的相关性。结果:以通过CGM获得的MAGE为因变量,以通过SMBG计算得出的CV、LAGE、MAGE1、SDBG、PPGE为自变量进行多元逐步回归分析,结果显示,通过CGM获得的MAGE与通过SMBG计算得出的CV、LAGE、MAGE1、SDBG、PPGE有关(P<0.05)。Spearman秩相关分析结果显示,通过CGM获得的MAGE与通过SMBG计算得出的CV、LAGE、MAGE1、SDBG、PPGE之间呈正相关(P<0.05)。结论:2型糖尿病患者CGM技术监测得出的MAGE与SMBG计算得出的CV、LAGE、MAGE1、SDBG、PPGE等血糖波动指标具有一定相关性,因此可通过SMBG计算得出的血糖波动指标反映2型糖尿病患者日内血糖波动情况。

葡萄糖目标范围内时间对血糖管理影响的研究进展与启示

随着持续葡萄糖监测技术的发展,葡萄糖目标范围内时间作为全新的血糖管理指标,在糖尿病病人的血糖控制中应用有独特的优势。该文从葡萄糖目标范围内时间的概述、对不同血糖管理指标的影响、目前的应用困境以及对血糖管理的启示等方面进行综述并提出建议与展望,旨在为葡萄糖目标范围内时间的进一步临床应用和实践提供参考。

实时葡萄糖监测在糖尿病患者血糖管理中的护理体会

目的 探究实时葡萄糖监测在糖尿病患者血糖管理中的护理体会。方法 选取2022年1月—2023年6月金湖县中医院收治的184例糖尿病患者,根据干预方式分为对照组和观察组,每组92例。对照组采用常规护理,观察组在对照组基础上加入实时葡萄糖监测护理,两组均连续干预7 d。比较两组患者护理满意度、血糖水平达标率。结果 观察组护理满意度(94.57%)高于对照组(83.70%),差异有统计学意义(χ^(2)=5.610,P<0.05);观察组血糖水平达标率(83.70%)高于对照组(70.65%),差异有统计学意义(χ^(2)=4.443,P<0.05)。结论 糖尿病患者护理中加入实时葡萄糖监测,可提高护理满意度、血糖水平达标率。