Prognostic impact of continuous glucose monitoring on herpetic neuralgia in elderly diabetic patients

WANG Bo; YU Bin; SHEN Qian-qian; XIA Ju-rong; DU Zhong-ju; YU Jian-ming

doi:10.13820/j.cnki.gdyx.20243880

Abstract：Objective To evaluate the clinical efficacy of continuous glucose monitoring(CGM)in the treatment of herpetic neuralgia in elderly patients with diabetes mellitus.Methods A total of 84 elderly diabetic patients with her-petic neuralgia hospitalized between December 2023 and September 2024 were enrolled and randomly assigned into two groups:a fingertip blood glucose monitoring group(n=42)and a continuous glucose monitoring group(n=42).The fin-gertip monitoring group underwent blood glucose tests before and after meals and at bedtime,and glucose-lowering thera-py was adjusted accordingly to maintain fasting glucose between 4.4-7 mmol/L and postprandial glucose＜10 mmol/L.The CGM group used a flash glucose monitoring system to continuously monitor glucose levels.Time in range(TIR),de-fined as the percentage of time within the target glucose range(3.9-10.0 mmol/L)over 24 hours,was calculated,and treatment was adjusted to maintain TIR＞70％over 14 days.Outcomes of herpetic neuralgia(recovery or development of postherpetic neuralgia)were compared.Correlation between TIR and prognosis was analyzed,and receiver operating char-acteristic(ROC)analysis was performed to evaluate the predictive value of TIR.Results The CGM group showed a sig-nificantly higher recovery rate from herpetic neuralgia compared with the fingertip group(P＜0.05).On day 14,the CGM group had a mean TIR of 85.9±6.2％.TIR was positively correlated with herpetic neuralgia prognosis(P＜0.01).ROC analysis revealed an AUC of 0.963(P＜0.01),with an optimal T1R cutoff value of 86.5％(Youden index=0.861).Conclusion Continuous glucose monitoring significantly improves the prognosis of herpetic neuralgia in elderly diabetic patients.A TIR threshold of 86.5％is recommended for clinical management in this population.