上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2022, Vol. 42 ›› Issue (9): 1171-1175.doi: 10.3969/j.issn.1674-8115.2022.09.002

• 院士论坛 • 上一篇    

血糖监测技术的进步与展望

贾伟平()   

  1. 上海交通大学医学院附属第六人民医院内分泌代谢科，上海市糖尿病临床医学中心，上海市糖尿病重点实验室，上海市糖尿病研究所，上海 200233
  • 收稿日期:2022-08-29 接受日期:2022-09-07 出版日期:2022-09-23 发布日期:2022-09-23
  • 通讯作者: 贾伟平 E-mail:wpjia@sjtu.edu.cn
  • 作者简介:贾伟平（1956—），女，中国工程院院士，主任医师，教授，博士；电子信箱：wpjia@sjtu.edu.cn。
  • 基金资助:
    上海市临床重点专科建设项目

New progress and prospects of blood glucose monitoring technology

JIA Weiping()   

  1. Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Clinical Center for Diabetes; Shanghai Key Laboratory of Diabetes Mellitus; Shanghai Diabetes Institute, Shanghai 200233, China
  • Received:2022-08-29 Accepted:2022-09-07 Online:2022-09-23 Published:2022-09-23
  • Contact: JIA Weiping E-mail:wpjia@sjtu.edu.cn
  • Supported by:
    Shanghai Municipal Key Clinical Specialty

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摘要：

血糖监测是糖尿病综合管理的重要组成部分。近1个多世纪以来，糖尿病监测技术由最初的尿糖检测，到后来的血糖检测，再到目前的持续葡萄糖监测（continuous glucose monitoring，CGM），不断向便捷、准确、微创，甚至无创的方向发展。近年来不断发展的CGM技术，可连续、动态地监测全天人体组织间液葡萄糖浓度的变化，发现不易被传统血糖监测方法探测到的隐匿性高血糖和低血糖。利用CGM技术提供的海量血糖信息，有望使糖尿病管理方案的制定更具针对性，真正做到精准控糖。而与之相应的，以葡萄糖目标范围内时间（time in range，TIR）为代表的血糖控制新指标备受关注，能更全面地提供包括高血糖、低血糖以及血糖波动等信息，与传统血糖指标糖化血红蛋白等互为补充。未来，应进一步研发舒适、稳定、准确性高的成熟、微创甚至无创血糖监测技术，以大幅提高患者血糖监测的体验感和积极性；同时，积极推动闭环胰岛素输注系统研发，真正实现个体化、自动化血糖控制，以进一步提高糖尿病患者的血糖控制水平。

关键词: 糖尿病, 持续葡萄糖监测, 葡萄糖目标范围内时间

Abstract:

Glucose monitoring is an important part of diabetes management. For over a century, diabetes monitoring technology has developed from the initial urine glucose test, to the later blood glucose test, and finally to the current continuous glucose monitoring (CGM), which is evolving in a more convenient, accurate, minimally invasive, and even non-invasive direction. CGM refers to the technology that continuously measures glucose concentrations in the subcutaneous interstitial fluid by glucose sensors. It can detect hyperglycemia and hypoglycemia that are not easily recognized by traditional monitoring methods. Using the huge amounts of glucose data generated by CGM technology, diabetes management is expected to be more targeted, with glucose control more accurate. In this context, novel measure of glucose control represented by time in range (TIR) has been popularized, which can provide comprehensive information including hyperglycemia, hypoglycemia, and glucose fluctuation. Hence, the modern approach to glucose control should focus not only on glycosylated hemoglobin, but also pay attention to new metrics such as TIR. In the future, more mature, minimally invasive and even non-invasive glucose monitoring technologies that are comfortable, stable and highly accurate should be further developed to greatly improve the experience and enthusiasm of the patients in blood glucose monitoring. Meanwhile, closed-loop insulin infusion system should be further developed, to truly realize individualized and automated glucose control, as well as further improvement of glucose control in the patients with diabetes.

Key words: diabetes mellitus, continuous glucose monitoring (CGM), time in range (TIR)

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