跟上全球形势,印度的糖尿病患病率正在上升。血糖控制不足是糖尿病相关发病率和死亡率的主要原因。糖尿病的常规护理标准(SOC),包括自我监测血糖和测量糖化血红蛋白,支持实现血糖控制,但也有一些限制。随着当前技术和指标的使用,如连续血糖监测(CGM)和标准化CGM数据报告,可以测量连续的实时葡萄糖水平,而且重要的是,上面的时间百分比,下面,并且在目标葡萄糖范围内可以计算,这有助于以患者为中心的护理,糖尿病管理的当前目标。国际共识建议支持将CGM和CGM数据报告纳入SOC以进行糖尿病管理。该指南为不同患者人群和不同类型的糖尿病提供了时间范围(TIR)阈值。然而,这些全球指南的推断并不能恰当地涵盖印度人口,饮食多样化,文化,和宗教习俗。在这种情况下,2021年在印度与糖尿病护理领域的专家举行了共识会议。会议的目的是为印度不同患者的TIR阈值制定共识建议。这些专家建议,加上基于证据的审查,在这里报道。该协议的目的是帮助印度各地的临床医生常规使用CGM和CGM数据报告来优化个性化糖尿病护理,通过实施TIR的临床目标。
Keeping up with the global scenario, diabetes prevalence is on rise in India. Inadequate glycemic control is a major cause of diabetes-related morbidity and mortality. The conventional standards of care (SOC) in diabetes, including self-monitoring of blood glucose and measurement of glycated hemoglobin, have supported achievement of glycemic control, yet there are a few limitations. With the use of current technologies and metrics, such as continuous glucose monitoring (CGM) and standardized CGM data reporting, the continuous real-time glucose levels can be measured, and importantly, the percentage of time above, below, and within the target glucose range can be calculated, which facilitates patient-centric care, a current goal in diabetes management. International
consensus recommendations endorse the incorporation of CGM and CGM data reporting in SOC for diabetes management. The
guidelines provide time in range (TIR) thresholds for different patient populations and different types of diabetes. However, extrapolation of these global
guidelines does not aptly cover the Indian population, which has diverse diet, culture, and religious practices. In this context, a
consensus meeting was held in India in 2021 with experts in the field of diabetes care. The purpose of the meeting was to develop
consensus recommendations for TIR thresholds for different patient profiles in India. Those expert recommendations, together with an evidence-based review, are reported here. The aim of this agreement is to aid clinicians across India to routinely use CGM and CGM data reports for optimizing individualized diabetes care, by implementing clinical targets for TIR.