Optimization of Insulin Regimen and Glucose Outcomes with Short-Term Real-Time Continuous Glucose Monitoring in Adult Type 1 Diabetes Patients with Suboptimal Control on Multiple Daily Injections: The Adult DIACCOR Study
| العنوان: | Optimization of Insulin Regimen and Glucose Outcomes with Short-Term Real-Time Continuous Glucose Monitoring in Adult Type 1 Diabetes Patients with Suboptimal Control on Multiple Daily Injections: The Adult DIACCOR Study |
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| المؤلفون: | Bruno Guerci, E. Leutenegger, S Picard, Hélène Hanaire, Pierre-Yves Benhamou, Yves Reznik, Salha Fendri, L. Dufaitre |
| المساهمون: | Point médical (Dijon), Service Endocrinologie - Diabétologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), CHU Amiens-Picardie, CHU Marseille, Margaux Society, Paris, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CCSD, Accord Elsevier |
| المصدر: | Diabetes Technology and Therapeutics Diabetes Technology and Therapeutics, Mary Ann Liebert, 2018, 20 (6), pp.403-412. ⟨10.1089/dia.2018.0002⟩ Diabetes Technology and Therapeutics, 2018, 20 (6), pp.403-412. ⟨10.1089/dia.2018.0002⟩ |
| بيانات النشر: | HAL CCSD, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Adult, Blood Glucose, Male, Pediatrics, medicine.medical_specialty, Adolescent, endocrine system diseases, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], 030209 endocrinology & metabolism, Hypoglycemia, Young Adult, 03 medical and health sciences, Insulin Infusion Systems, 0302 clinical medicine, Endocrinology, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Insulin, In patient, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, Aged, 80 and over, Glycated Hemoglobin, Type 1 diabetes, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Continuous glucose monitoring, business.industry, Blood Glucose Self-Monitoring, nutritional and metabolic diseases, Middle Aged, medicine.disease, [SDV] Life Sciences [q-bio], Medical Laboratory Technology, Diabetes Mellitus, Type 1, Female, Adult type, business, Insulin regimen, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| الوصف: | The impact of a 7-day real-time continuous glucose monitoring (RT-CGM) on type 1 diabetes (T1D) management remains unclear in patients suboptimally controlled by multiple daily injections (MDI). The DIACCOR Study aimed to describe treatment decisions and glucose outcomes after a short-term RT-CGM sequence.This French multicenter longitudinal observational study included T1D patients with HbA1c7.5% or history of severe hypoglycemia (SH) or recurrent documented hypoglycemia. A sensor was inserted at the inclusion visit, treatment changes were proposed by the investigator within 7-15 days ("INT" = MDI intensification, "CSII" = switch to continuous insulin infusion, or "ER" = educational reinforcement with no change in insulin regimen), and a 4-month follow-up visit (M4) was scheduled.Four hundred fifty-nine patients were recruited by 155 diabetologists, 17.0% had SH history, and 24.2% had recurrent hypoglycemia. Baseline HbA1c was 8.34% ± 1.21% (7.5% in 79.6%). Overall, 253 (64.4%), 64 (16.3%), and 76 patients (19.3%) were, respectively, included in the "INT," "CSII," and "ER" subgroups. The number of patients who experienced SH or recurrent hypoglycemia dropped dramatically (7.9% vs. 17.0% and 10.8% vs. 24.2%, respectively). The same trend was observed for ketoacidosis and ketosis (0.3% vs. 3.3% and 2.2% vs. 4.8%). At M4, HbA1c was significantly reduced in the whole cohort to 7.98% ± 1.01% (P 0.0001). The adjusted differences in HbA1c level in the INT, CSII, and ER subgroups were, respectively, -0.32%, -0.69%, and -0.50% (P 0.0001 for all).In real-life setting, a 1-week diagnostic RT-CGM supports appropriate treatment changes in patients with uncontrolled T1D resulting in better glucose control and less hypoglycemia. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1520-9156 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e48f7b2a1363e8ad191e3b02cf75bb46Test https://hal.univ-grenoble-alpes.fr/hal-01930592/documentTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e48f7b2a1363e8ad191e3b02cf75bb46 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15209156 |
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