Sustained benefit of continuous glucose monitoring on A1C, glucose profiles, and hypoglycemia in adults with type 1 diabetes
Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Bruce Bode, Roy W Beck, Dongyuan Xing, Lisa Gilliam, Irl Hirsch, Craig Kollman, Lori Laffel, Katrina J Ruedy, William V Tamborlane, Stuart Weinzimer, Howard Wolpert, Irl B Hirsch, Lisa K Gilliam, Kathy Fitzpatrick, Dori Khakpour, Stuart A Weinzimer, William V Tamborlane, Brett Ives, Joan Bosson-Heenan, Howard Wolpert, Greeshma Shetty, Astrid Atakov-Castillo, Judith Giusti, Stacey O'Donnell, Suzanne Ghiloni, Bruce W Bode, Kelli O'Neil, Lisa Tolbert, Tim Wysocki, Larry A Fox, Nelly Mauras, Kimberly Englert, Joe Permuy, Bruce Buckingham, Darrell M Wilson, Jennifer Block, Kari Benassi, Eva Tsalikian, Michael Tansey, Debra Kucera, Julie Coffey, Joanne Cabbage, Lori Laffel, Kerry Milaszewski, Katherine Pratt, Elise Bismuth, Joyce Keady, Margie Lawlor, H Peter Chase, Rosanna Fiallo-Scharer, Paul Wadwa, Laurel Messer, Victoria Gage, Patricia Burdick, Jean M Lawrence, Robert Clemons, Michelle Maeva, Bonnie Sattler, Roy W Beck, Katrina J Ruedy, Craig Kollman, Dongyuan Xing, Judy Jackson, Michael Steffes, Jean M Bucksa, Maren L Nowicki, Carol Van Hale, Vicky Makky, Michael O'Grady, Elbert Huang, Anirban Basu, David O Meltzer, Lan Zhao, Joyce Lee, Aaron J Kowalski, Lori Laffel, William V Tamborlane, Roy W Beck, Aaron J Kowalski, Katrina J Ruedy, Ruth S Weinstock, Barbara J Anderson, Davida Kruger, Lisa LaVange, Henry Rodriguez, Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Bruce Bode, Roy W Beck, Dongyuan Xing, Lisa Gilliam, Irl Hirsch, Craig Kollman, Lori Laffel, Katrina J Ruedy, William V Tamborlane, Stuart Weinzimer, Howard Wolpert, Irl B Hirsch, Lisa K Gilliam, Kathy Fitzpatrick, Dori Khakpour, Stuart A Weinzimer, William V Tamborlane, Brett Ives, Joan Bosson-Heenan, Howard Wolpert, Greeshma Shetty, Astrid Atakov-Castillo, Judith Giusti, Stacey O'Donnell, Suzanne Ghiloni, Bruce W Bode, Kelli O'Neil, Lisa Tolbert, Tim Wysocki, Larry A Fox, Nelly Mauras, Kimberly Englert, Joe Permuy, Bruce Buckingham, Darrell M Wilson, Jennifer Block, Kari Benassi, Eva Tsalikian, Michael Tansey, Debra Kucera, Julie Coffey, Joanne Cabbage, Lori Laffel, Kerry Milaszewski, Katherine Pratt, Elise Bismuth, Joyce Keady, Margie Lawlor, H Peter Chase, Rosanna Fiallo-Scharer, Paul Wadwa, Laurel Messer, Victoria Gage, Patricia Burdick, Jean M Lawrence, Robert Clemons, Michelle Maeva, Bonnie Sattler, Roy W Beck, Katrina J Ruedy, Craig Kollman, Dongyuan Xing, Judy Jackson, Michael Steffes, Jean M Bucksa, Maren L Nowicki, Carol Van Hale, Vicky Makky, Michael O'Grady, Elbert Huang, Anirban Basu, David O Meltzer, Lan Zhao, Joyce Lee, Aaron J Kowalski, Lori Laffel, William V Tamborlane, Roy W Beck, Aaron J Kowalski, Katrina J Ruedy, Ruth S Weinstock, Barbara J Anderson, Davida Kruger, Lisa LaVange, Henry Rodriguez
Abstract
Objective: To evaluate long-term effects of continuous glucose monitoring (CGM) in intensively treated adults with type 1 diabetes.
Research design and methods: We studied 83 of 86 individuals >or=25 years of age with type 1 diabetes who used CGM as part of a 6-month randomized clinical trial in a subsequent 6-month extension study. RESULTS After 12 months, median CGM use was 6.8 days per week. Mean change in A1C level from baseline to 12 months was -0.4 +/- 0.6% (P < 0.001) in subjects with baseline A1C >or=7.0%. A1C remained stable at 6.4% in those with baseline A1C <7.0%. The incidence rate of severe hypoglycemia was 21.8 and 7.1 events per 100 person-years in the first and last 6 months, respectively. Time per day with glucose levels in the range of 71-180 mg/dl increased significantly (P = 0.02) from baseline to 12 months.
Conclusions: In intensively treated adults with type 1 diabetes, CGM use and benefit can be sustained for 12 months.
Trial registration: ClinicalTrials.gov NCT00406133.
References
- The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med 2008359:1464–1476
- The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Diabetes Care 2009;32:1378–1383
- JDRF CGM Study Group. JDRF randomized clinical trial to assess the efficacy of real-time continuous glucose monitoring in the management of type 1 diabetes: research design and methods. Diabetes Technol Ther 2008;10:310–321
- Gibb I, Parnham A, Fonfrède M, Lecock F: Multicenter evaluation of Tosoh glycohemoglobin analyzer. Clin Chem 1999;45:1833–1841
- The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993;329:977–986
- The DCCT Research Group. Epidemiology of severe hypoglycemia in the Diabetes Control and Complications Trial. Am J Med 1991;90:450–459
- Fanelli CG, Epifano L, Rambotti AM, Pampanelli S, Di Vincenzo A, Modarelli F, Lepore M, Annibale B, Ciofetta M, Bottini P: Meticulous prevention of hypoglycemia normalizes the glycemic thresholds and magnitude of most of neuroendocrine responses to, symptoms of, and cognitive function during hypoglycemia in intensively treated patients with short-term IDDM. Diabetes 1993;42:1683–1689
- Kovatchev BP, Cox DJ, Gonder-Frederick LA, Clarke W: Symmetrization of the blood glucose measurement scale and its applications. Diabetes Care 1997;20:1655–1658
Source: PubMed