RESUMO
INTRODUCTION: There are data capture devices that attach to the FreeStyle Libre sensor and convert its communication from NFC (Near-field communication) to Bluetooth technology, generating real-time continuous glucose monitoring. The accuracy of hypoglycemia measurements displayed by smartphone apps using this device has not been established. METHODS: Study of diagnostic tests. Numerical accuracy was evaluated, utilizing the absolute difference with respect to capillary glucometry (ISO 15197:2015 standard) and clinical accuracy, using the Clarke and Parkes (Consensus) error grids, for glucose measurements less than 70mg/dL performed with the FreeStyle Libre system and with the digital estimation xDrip+ app, in diabetic patients managed with insulin therapy. RESULTS: Twenty-seven patients were included (TIR 73.4%, TBR70 5.6%), who contributed 83 hypoglycemic events. Numerical accuracy was adequate in similar proportions with the FreeStyle Libre system compared to the xDrip+ app (81.92% vs. 68.67%, p=0.0630). The clinical accuracy evaluation showed that 92.8% of the measurements for xDrip+ and 98.8% for FreeStyle libre met the criteria according to the Parkes (Consensus) grid (p=0.0535); and 79.5% and 91.6% of the measurements met the criteria according to the Clarke grid (p=0.0273), being higher with FreeStyle libre. CONCLUSIONS: The use of the NFC-Bluetooth transmitter (Miao-Miao) associated with the xDrip+ app does not improve numerical or clinical accuracy for detecting hypoglycemic events in diabetic patients managed with insulin therapy, compared to the FreeStyle Libre device.
Assuntos
Diabetes Mellitus Tipo 1 , Hipoglicemia , Humanos , Insulina , Automonitorização da Glicemia , Glicemia , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemia/induzido quimicamente , Hipoglicemiantes/efeitos adversosRESUMO
Objetivo: determinar el cambio en la refracción relacionado con el aumento agudo de la glucemia posprandial y su variación, en pacientes voluntarios no diabéticos de la población adulta mayor de dieciocho años de Bucaramanga y su área metropolitana. Metodología: se realizó un estudio cuasiexperimental tipo antes y después, en 47 personas, en el que se evaluaron variables médicas: peso, talla, índice cintura cadera, índice de masa corporal; variables de laboratorio: glucometría y hemoglobina glucosilada, y variables refractivas, defecto refractivo y refracción. Se realizó unanálisis univariado de acuerdo con el nivel de medición de cada una de las variables, posteriormente para el análisis de las mediciones repetidas se realizaron pruebas de Friedman. Resultados: se presentaron diferencias en la refracción para OD entre -0,75 y +0,75 D y para OI entre -1,00 y-0,50 D; las variaciones de la refracción en los cinco exámenes no fue estadísticamente significativa, con un Friedman para OD 1,0426 con p 0,3072 y para OI 0,5319 con p 0,4658. Conclusiones: las variaciones en la refracción durante la curva de tolerancia oral a la glucosa no son clínica ni estadísticamente significativas.
Objective: To determine the change in refraction in regards to the sharp increase of postprandial glycaemia and its variations in voluntary, non-diabetic patients among the adult population in Bucaramanga and its metropolitan area. Methodology: A before/after quasi-experimental study was carried out among 47 people, where the following medical variables were evaluated: weight, measurements, waist-to-hip ratio, body mass index; laboratory variables: glucometry and glycated hemoglobin, as well as refractive variables, refractive error and refraction. A univariate analysis was made according to the measurement level of each variable, and Friedman Tests were subsequently performed in order to analyze duplicate measurements. Results: Results showed refraction differences of -0.75 to +0.75 D for OD, and of -1.00 to -0.50 D for OS; the refraction variations in the five test were not statistically meaningful, showing Friedman results of 1.0426 with p 0.3072 for OD and 0.5319 with p 0.4658 for OS. Conclusions: Refraction variations during oral glucose tolerance test are neither clinically nor statistically meaningful.