Continuous Glucose Monitoring Helps Even Well Controlled Type 1 Diabetics

 

The study, conducted by the The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, involved 129 children and adults with type 1 diabetes who were maintaining their A1C levels below 7.0% with intensive insulin therapy. 

 

Participants were randomly assigned either to continuous glucose monitoring with an insulin pump (n=67) or to standard home monitoring (n=62) with a blood glucose meter and test strips, with testing done at least 4 times daily. 

 

According to Dr. Roy W. Beck from the Jaeb Center for Health Research in Tampa, Florida and his co-authors, the major limiting factor for achieving euglycemia in patients with type 1 diabetes is hypoglycemia. 

 

In fact, the investigators found that median time with a glucose level of 60 mg/dL or lower was significantly less in the continuous monitoring group (18 min/day, vs 35 min/d with standard monitoring, p=0.05). 

 

Time out of range -- 70 mg/dL or less, or > 180 mg/dL -- was also significantly lower with continuous monitoring (377 min/d) than with standard monitoring (491 min/d, p = 0.003). 

 

There was no difference between groups, however, in the number of patients who suffered at least one severe hypoglycemic event. 

 

At 26 weeks, there was a significant difference in mean A1C level favoring the continuous monitoring group (6.4 vs 6.8, p < 0.001). At the same time point, more subjects in the continuous monitoring group had A1C levels below 7.0% (88% vs 63%, p < 0.001) 

 

“Based on the weight of evidence,” the authors conclude, “continuous glucose monitoring is beneficial for adults and children with type 1 diabetes who already have achieved excellent control with home glucose monitoring.” 

 

Reference:

Diabetes Care 2009;32:1378-1383.

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