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Switching from flash glucose monitoring to continuous glucose monitoring on hypoglycemia in adults with type 1 diabetes at high hypoglycemia risk: the extension phase of the I HART CGM study

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العنوان: Switching from flash glucose monitoring to continuous glucose monitoring on hypoglycemia in adults with type 1 diabetes at high hypoglycemia risk: the extension phase of the I HART CGM study
المؤلفون: Reddy, M, Jugnee, N, Anantharaja, S, Oliver, N
المصدر: 757 ; 751
بيانات النشر: Mary Ann Liebert
سنة النشر: 2018
المجموعة: Imperial College London: Spiral
مصطلحات موضوعية: Science & Technology, Life Sciences & Biomedicine, Endocrinology & Metabolism, Continuous Glucose monitoring, Flash glucose monitoring, Type 1 diabetes, Hypoglycemia, IMPAIRED AWARENESS, INSULIN INJECTIONS, MULTICENTER, MORTALITY, SYSTEMS, Adult, Blood Glucose, Blood Glucose Self-Monitoring, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin A, Humans, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Male, Middle Aged, Prospective Studies, Risk Factors, Treatment Outcome
الوصف: Background: The I HART CGM study showed that real-time continuous glucose monitoring (RT-CGM) has greater beneficial impact on hypoglycemia than intermittent flash glucose monitoring (flash) in adults with type 1 diabetes (T1D) at high risk. The impact of continuing RT-CGM or switching from flash to RT-CGM for another 8 weeks was then evaluated. Methods: Prospective randomized parallel group study with an extension phase. After a 2-week run-in with blinded CGM, participants were randomized to either RT-CGM or flash for 8 weeks. All participants were then given the option to continue with RT-CGM for another 8 weeks. Glycemic outcomes at 8 weeks are compared with the 16-week endpoint. Results: Forty adults with T1D on intensified multiple daily insulin injections and with impaired awareness of hypoglycemia or a recent episode of severe hypoglycemia were included (40% female, median [IQR] age 49.5 [37.5–63.5] years, diabetes duration 30.0 [21.0–36.5] years, HbA1c 56 [48–63] mmol/mol, and Gold Score 5 [4–5]), of whom 36 completed the final 16-week extension. There was a significant reduction in percentage time in hypoglycemia (<3.0 mmol/L) in the group switching from flash to RT-CGM (from 5.0 [3.7–8.6]% to 0.8 [0.4–1.9]%, P = 0.0001), whereas no change was observed in the RT-CGM group continuing with the additional 8 weeks of RT-CGM (1.3 [0.4–2.8] vs. 1.3 [0.8–2.5], P = 0.82). Time in target (3.9–10 mmol/L) increased in the flash group after switching to RT-CGM (60.0 [54.5–67.8] vs. 67.4 [56.3–72.4], P = 0.02) and remained the same in the RT-CGM group that continued with RT-CGM (65.9 [54.1–74.8] vs. 64.9 [49.2–73.9], P = 0.64). Conclusions: Our data suggest that switching from flash to RT-CGM has a significant beneficial impact on hypoglycemia outcomes and that continued use of RT-CGM maintains hypoglycemia risk benefit in this high-risk population.
نوع الوثيقة: article in journal/newspaper
اللغة: English
تدمد: 1520-9156
العلاقة: Diabetes Technology and Therapeutics; http://hdl.handle.net/10044/1/71298Test; https://dx.doi.org/10.1089/dia.2018.0252Test
DOI: 10.1089/dia.2018.0252
الإتاحة: https://doi.org/10.1089/dia.2018.0252Test
http://hdl.handle.net/10044/1/71298Test
حقوق: © Monika Reddy, et al., 2018; Published by Mary Ann Liebert, Inc. This Open Access article is distributed under the terms of theCreative Commons License (http://creativecommons.org/licenses/by/4.0Test), which permits unrestricted use, distribution, and reproduction inany medium, provided the original work is properly credited.
رقم الانضمام: edsbas.CF911A16
قاعدة البيانات: BASE
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