2020, Número 1
<< Anterior Siguiente >>
Rev Mex Pediatr 2020; 87 (1)
Impacto de la utilización de sistemas de medición de glucosa intersticial en el control glucémico en pacientes pediátricos con diabetes mellitus tipo 1
Barbed-Ferrández SM, Montaner-Gutiérrez T, Larramona-Ballarín G, Ferrer‑Lozano M, Lou‑Francés GM
Idioma: Español
Referencias bibliográficas: 20
Paginas: 13-17
Archivo PDF: 229.48 Kb.
RESUMEN
Introducción: El adecuado control glucémico en la diabetes mellitus tipo 1 (DM-1) es fundamental. Existen sistemas de medición de glucosa intersticial (MGI) que permiten realizar ajustes terapéuticos más específicos. El objetivo del estudio fue determinar el impacto de sistemas MGI en el control glucémico en pacientes menores de 18 años con DM-1.
Material y métodos: Estudio de tipo cohorte retrospectiva. Los datos se recogieron de la historia clínica del paciente y de una encuesta realizada a los pacientes y sus padres o tutores.
Resultados: De un total de 120 pacientes, 63 utilizaban un sistema MGI; después de seis meses de su uso se observó reducción significativa (p ‹ 0.05) de las cifras de hemoglobina glucosilida, pasando de 7.5% ± 0.6 a 7.13% ± 0.47. Además, hubo disminución significativa de la variabilidad glucémica, del número de glucemias capilares y de la frecuencia de hipoglucemias leve y grave.
Conclusiones: Los sistemas MGI ayudan a mejorar el control glucémico de los pacientes pediátricos con DM-1.
REFERENCIAS (EN ESTE ARTÍCULO)
Levitsky LL, Misra M. Management of type 1 diabetes mellitus in children and adolescents. Post TW, ed. UpToDate. Hoppin AG: UpToDate Inc. [Access August 2019] Available in: https://www.uptodate.com.
Chiang JL, Kirkman MS, Laffel LM, Peters AL. Type 1 diabetes through the life span: a position statement of the American Diabetes Association. Diabetes Care. 2014; 37: 2034.
American Diabetes Association. Children and Adolescents: Standards of Medical Care in Diabetes-2018. Position statements. Diabetes Care. 2018; 41 (Supplement 1): S126-S136. doi: 10.2337/dc18-S012.
Torres LM, Barrio CR, García CB, Gómez GA, González CI, Hermoso LF et al. Estado actual y recomendaciones sobre la utilización de los sistemas de monitorización continua de glucosa en niños y adolescentes con diabetes mellitus tipo 1. An Pediatr (Barc). 2011; 75(2): 134.e1-134.e6.
Giménez M, Diaz-Soto G, Andía V, Ruiz de Adana MS, García-Cuartero B, Rigla M et al. Documento de Consenso SED-SEEP sobre el uso de la MCG en España. Grupo de Trabajo de Tecnologías aplicadas a la Diabetes de la SED y de la SEEP. España. 2017.
Taddeo RL, Moser JT, Minnock PP. Continuous glucose monitoring in Pediatrics: the gap between potential benefits and the reality of utility. Pediatr Endocrinol Rev. 2017; 14 (Supplement 2): 435-440.
De Salvo D, Miller K, Hermann J, Maahs D, Hofer S, Clements M et al. Continuous Glucose Monitoring (CGM) and Glycemic Control Among Youth with Type 1 Diabetes (T1D): International comparison from the T1D Exchange (T1DX) and the DPV Initiative. 43rd Annual Conference of the International Society for Pediatric and Adolescent Diabetes; Innsbruck, Austria 2017.
Sherr JL, Tauschman M, Battelino T, De Bock M, Forlenza G, Roman R et al. ISPAD Clinical Practice Consensus Guidelines 2018: diabetes technologies. Pediatr Diabetes. 2018; 19 (Suppl 27): 302-325. doi: 10.1111/pedi.12731.
Battelino T, Phillip M, Bratina N, Nimri R, Oskarsson P, Bolinder J. Effect on continuous glucose monitoring on hypoglycemia in type 1 diabetes. Diabetes Care. 2011; 34: 795-800.
Chase HP, Beck RW, Xing D, Tamborlane WV, Coffey J, Fox LA et al. Continuous glucose monitoring in youth with type 1 diabetes: 12-month follow-up of the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial. Diabetes Technol Ther. 2010; 12(7): 507-515.
The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Effectiveness of continuous glucose monitoring in a clinical care environment: evidence from the Juvenile Diabetes Research Foundation continuous glucose monitoring (JDRFCGM) trial. Diabetes Care. 2010: 33: 17-22.
Ludvigsson J, Hanas R. Continuous subcutaneous glucose monitoring improved metabolic control in pediatric patients with type 1 diabetes: a controlled crossover study. Pediatrics. 2003; 111: 933-938.
Tamborlane WV, Beck RW, Bode BW, Buckingham B, Chase HP, Clemons R et al. The 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: 1464-1476.
Beck RW, Buckingham B, Miller K, Wolpert H, Xing D, Block JM et al. Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes. Diabetes Care. 2009; 32(11): 1947-1953.
Pickup JC, Freeman SC, Sutton AJ. Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data. BMJ. 2011; 343: d3805.
Battelino T, Conget I, Olsen B, Schutz-Fuhrmann I, Hommel E, Hoogma R et al. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia. 2012; 55(12): 3155-3162.
Bergenstal RM, Tamborlane WV, Ahmann A, Buse JB, Dailey G, Davis SN et al. Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med. 2010; 363: 311-320.
Messer LH, Johnson R, Driscoll KA, Jones J. Systematic review or meta-analysis best friend or spy: a qualitative meta-synthesis on the impact of continuous glucose monitoring on life with type 1 diabetes. Diabet Med. 2018; 35(4): 409-418. doi: 10.1111/dme.13568.
James S, Perry L, Gallagher R, Lowe J. Diabetes educators: perceived experiences, supports and barriers to use of common diabetes-related technologies. J Diabetes Sci Technol. 2016; 10: 1115-1121.
Wysocki T, Hirschfeld F, Miller L, Izenberg N, Dowshen SA, Taylor A et al. Consideration of insulin pumps or continuous glucose monitors by adolescents with type 1 diabetes and their parents: stakeholder engagement in the design of web-based decision aids. Diabetes Educ. 2016; 42: 395-407.