We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
REPLACE-BG: A Randomized Trial Comparing Continuous Glucose Monitoring With and Without Routine Blood Glucose Monitoring in Adults With Well-Controlled Type 1 Diabetes.
- Authors
Aleppo, Grazia; Ruedy, Katrina J.; Riddlesworth, Tonya D.; Kruger, Davida F.; Peters, Anne L.; Hirsch, Irl; Bergenstal, Richard M.; Toschi, Elena; Ahmann, Andrew J.; Shah, Viral N.; Rickels, Michael R.; Bode, Bruce W.; Philis-Tsimikas, Athena; Pop-Busui, Rodica; Rodriguez, Henry; Eyth, Emily; Bhargava, Anuj; Kollman, Craig; Beck, Roy W.; REPLACE-BG Study Group
- Abstract
<bold>Objective: </bold>To determine whether the use of continuous glucose monitoring (CGM) without confirmatory blood glucose monitoring (BGM) measurements is as safe and effective as using CGM adjunctive to BGM in adults with well-controlled type 1 diabetes (T1D).<bold>Research Design and Methods: </bold>A randomized noninferiority clinical trial was conducted at 14 sites in the T1D Exchange Clinic Network. Participants were ≥18 years of age (mean 44 ± 14 years), had T1D for ≥1 year (mean duration 24 ± 12 years), used an insulin pump, and had an HbA1c ≤9.0% (≤75 mmol/mL) (mean 7.0 ± 0.7% [53 ± 7.7 mmol/mol]); prestudy, 47% were CGM users. Participants were randomly assigned 2:1 to the CGM-only (n = 149) or CGM+BGM (n = 77) group. The primary outcome was time in range (70-180 mg/dL) over the 26-week trial, with a prespecified noninferiority limit of 7.5%.<bold>Results: </bold>CGM use averaged 6.7 ± 0.5 and 6.8 ± 0.4 days/week in the CGM-only and CGM+BGM groups, respectively, over the 26-week trial. BGM tests per day (including the two required daily for CGM calibration) averaged 2.8 ± 0.9 and 5.4 ± 1.4 in the two groups, respectively (P < 0.001). Mean time in 70-180 mg/dL was 63 ± 13% at both baseline and 26 weeks in the CGM-only group and 65 ± 13% and 65 ± 11% in the CGM+BGM group (adjusted difference 0%; one-sided 95% CI -2%). No severe hypoglycemic events occurred in the CGM-only group, and one occurred in the CGM+BGM group.<bold>Conclusions: </bold>Use of CGM without regular use of confirmatory BGM is as safe and effective as using CGM with BGM in adults with well-controlled T1D at low risk for severe hypoglycemia.
- Subjects
BLOOD sugar monitoring; TYPE 1 diabetes; INSULIN pumps; HYPOGLYCEMIA; DISEASES in adults; PATIENTS; BLOOD sugar analysis; COMPARATIVE studies; GLYCOSYLATED hemoglobin; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; STATISTICAL sampling; SOCIOECONOMIC factors; EVALUATION research; RANDOMIZED controlled trials
- Publication
Diabetes Care, 2017, Vol 40, Issue 4, p538
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/dc16-2482