According to a report in the August 2009 issue of Diabetes Care, even when patients with type 1 diabetes have excellent hemoglobin A1C levels, continuous glucose monitoring will be beneficial.
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.”
Diabetes Care 2009;32:1378-1383.
Even when patients with type 1 diabetes have excellent hemoglobin A1C levels, continuous glucose monitoring will be beneficial, according to a report in the August issue of Diabetes Care.