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The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Diabetes care Beck, R. W., Hirsch, I. B., Laffel, L., Tamborlane, W. V., Bode, B. W., Buckingham, B., Chase, P., Clemons, R., Fiallo-Scharer, R., Fox, L. A., Gilliam, L. K., Huang, E. S., Kollman, C., Kowalski, A. J., Lawrence, J. M., Lee, J., Mauras, N., O'Grady, M., Ruedy, K. J., Tansey, M., Tsalikian, E., Weinzimer, S. A., Wilson, D. M., Wolpert, H., Wysocki, T., Xing, D. 2009; 32 (8): 1378-1383

Abstract

OBJECTIVE The potential benefits of continuous glucose monitoring (CGM) in the management of adults and children with well-controlled type 1 diabetes have not been examined. RESEARCH DESIGN AND METHODS A total of 129 adults and children with intensively treated type 1 diabetes (age range 8-69 years) and A1C <7.0% were randomly assigned to either continuous or standard glucose monitoring for 26 weeks. The main study outcomes were time with glucose level < or =70 mg/dl, A1C level, and severe hypoglycemic events. RESULTS At 26 weeks, biochemical hypoglycemia (< or =70 mg/dl) was less frequent in the CGM group than in the control group (median 54 vs. 91 min/day), but the difference was not statistically significant (P = 0.16). Median time with a glucose level < or =60 mg/dl was 18 versus 35 min/day, respectively (P = 0.05). Time out of range (< or =70 or >180 mg/dl) was significantly lower in the CGM group than in the control group (377 vs. 491 min/day, P = 0.003). There was a significant treatment group difference favoring the CGM group in mean A1C at 26 weeks adjusted for baseline (P < 0.001). One or more severe hypoglycemic events occurred in 10 and 11% of the two groups, respectively (P = 1.0). Four outcome measures combining A1C and hypoglycemia data favored the CGM group in comparison with the control group (P < 0.001, 0.007, 0.005, and 0.003). CONCLUSIONS Most outcomes, including those combining A1C and hypoglycemia, favored the CGM group. The weight of evidence suggests that CGM is beneficial for individuals with type 1 diabetes who have already achieved excellent control with A1C <7.0%.

View details for DOI 10.2337/dc09-0108

View details for PubMedID 19429875

View details for PubMedCentralID PMC2713649