Continuous glucose monitoring beneficial for adults, children with well-controlled type 1 diabetes

Researchers observed a beneficial effect among adults and children with type 1 diabetes who previously achieved excellent glucose control and utilized continuous glucose monitoring.

“The benefit is seen in a reduction in the amount of times per day with hypoglycemia while being able to maintain near-normal HbA1c levels,” Roy W. Beck, MD, of the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, told Endocrine Today. “The Diabetes Control and Complications Trial showed that with intensive insulin therapy, excellent blood glucose control could be obtained, but at the expense of a considerable increase in hypoglycemia. However, the current study shows that continuous glucose monitoring provides an additional step towards optimizing control by providing the patient with a tool that can reduce hypoglycemia.”

Beck and colleagues randomly assigned 129 adults and children aged between 8 and 69 with intensely treated type 1 diabetes and an HbA1c <7% to either continuous (n=67) or standard glucose monitoring (n=62) for 26 weeks.

Although not statistically significant, the researchers identified less frequent biochemical hypoglycemia in the continuous glucose monitoring group compared with the control group at the end of 26 weeks.

A greater number of improvements in HbA1c (≥0.3%) were found in the continuous monitoring group. Fewer patients in the continuous monitoring group had a worsening of HbA1c ≥0.3% and more patients in this group had an HbAc1 level <7% at 26 weeks (P<.001).

In addition, 28% of patients in the continuous monitoring group had a decrease in HbA1c ≥0.3% without having a severe hypoglycemic event vs. 5% of patients in the control group (P<.001).

Data further indicated that the median time per day with a glucose level ≤70 mg/dL decreased from 91 minutes at baseline to 54 minutes at the end of 26 weeks for patients in the continuous monitoring group (P=.002) compared with a decrease from 96 minutes to 91 minutes among patients in the control group (P=.43).

“Continuous glucose monitoring may be beneficial for patients with type 1 diabetes who have achieved excellent glycemic control by using either an insulin pump or multiple daily injections of insulin and who have been monitoring with a home blood glucose meter multiple times a day,” Beck said. “Since almost all such patients under tight control experience periods of hypoglycemia, there is potential for benefit using continuous glucose monitoring for patients who have HbA1c <7.0%.” – by Jennifer Southall

Bode B. Diabetes Care. 2009;doi:10.2337/dc09-0108.