In a nutshell
This study investigated the effect of continuous glucose monitoring (CGM) in managing blood sugar levels in patients with type 1 diabetes treated with multiple daily insulin injections. They found CGM resulted in a clinically meaningful improvement in glycemic (blood sugar) control.
Glycemic control is critical for patients with type 1 diabetes. Patients may administer multiple daily injections of insulin and/or receive insulin through a subcutaneous (under the skin) pump to maintain glycemic control. In order to monitor this there are a number of strategies. Conventional therapy involves self-measurement of blood glucose levels. Continuous glucose monitoring (CGM) is a new strategy whereby a patient’s blood sugar is monitored constantly via a subcutaneous sensor.
Some studies suggest that CGM may be useful for monitoring blood sugar in some patients. As of yet, CGM has not been investigated in patients solely receiving multiple daily insulin injections.
Methods & findings
This study included 142 patients with type 1 diabetes. They were randomly selected to be part of the CGM or conventional therapy groups first. They received treatment for 26 weeks. Following this, patients underwent a 17-week washout period – during this time all patients underwent conventional therapy. Patients then completed 26 weeks of the opposite therapy. HbA1c levels (average blood glucose over 3 months) were measured at 2, 4 13 and 26 weeks during each phase of the study. HbA1c levels at the end of each 26 week period were compared.
Average HbA1c at the start of the study was 8.6%. Average HbA1c levels were 7.92% following CGM and 8.35% following conventional therapy. In addition, patients undergoing CGM reported increased well-being, treatment satisfaction and reduced distress and fear associated with diabetes and hypoglycemia (dangerously low blood glucose).
Five patients experienced hypoglycemia during coventional therapy. One patient experienced hypoglycemia during CGM. Seven patients experienced hypoglycemia during the washout period.
The bottom line
This study found that glycemic control was improved in patients undergoing CGM.
The fine print
There was an absence of follow-up data for 19 patients. Patients were also not blinded do due the nature of the intervention.This study was also performed in predominantly Caucasian patients.
If you are having issues with glycemic control or have any questions then you should discuss them with your physician.
Published By :
Journal of the American Medical Association (JAMA)
Jan 24, 2017
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