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- Title
Assessment of Patient-Led or Physician-Driven Continuous Glucose Monitoring in Patients With Poorly Controlled Type 1 Diabetes Using Basal-Bolus Insulin Regimens.
- Authors
Riveline, Jean-Pierre; Schaepelynck, Pauline; Chaillous, Lucy; Renard, Eric; Sola-Gazagnes, Agnès; Penfornis, Alfred; Tubiana-Rufi, Nadia; Sulmont, Véronique; Catargi, Bogdan; Lukas, Céline; Radermecker, Régis P.; Thivolet, Charles; Moreau, François; Benhamou, Pierre-Yves; Guerci, Bruno; Leguerrier, Anne-Marie; Millot, Luc; Sachon, Claude; Charpentier, Guillaume; Hanaire, Hélène
- Abstract
OBJECTIVE--The benefits of real-time continuous glucose monitoring (CGM) have been demonstrated in patients with type 1 diabetes. Our aim was to compare the effect of two modes of use of CGM, patient led or physician driven, for 1 year in subjects with poorly controlled type 1 diabetes. RESEARCH DESIGN AND METHODS--Patients with type 1 diabetes aged 8-60 years with HbA1c $8% were randomly assigned to three groups (1:1:1). Outcomes for glucose control were assessed at 1 year for two modes of CGM (group 1: patient led; group 2: physician driven) versus conventional self-monitoring of blood glucose (group 3: control). RESULTS--A total of 257 subjects with type 1 diabetes underwent screening. Of these, 197 were randomized, with 178 patients completing the study (age: 36 ± 14 years; HbA1c: 8.9 ± 0.9%). HbA1c improved similarly in both CGM groups and was reduced compared with the control group (group 1 vs. group 3:20.52%, P = 0.0006; group 2 vs. group 3:20.47%, P = 0.0008; groups 1 + 2 vs. group 3:20.50%, P<0.0001). The incidence of hypoglycemia was similar in the three groups. Patient SF-36 questionnaire physical health score improved in both experimental CGM groups (P = 0.004). Sensor consumption was 34% lower in group 2 than in group 1 (median [Q1-Q3] consumption: group 1: 3.42/month [2.20-3.91] vs. group 2: 2.25/month [1.27-2.99], P = 0.001). CONCLUSIONS--Both patient-led and physician-driven CGM provide similar long-term improvement in glucose control in patients with poorly controlled type 1 diabetes, but the physician-driven CGM mode used fewer sensors.
- Subjects
GLUCOSE; ENDOCRINE diseases; DIABETES; PATIENTS; INSULIN
- Publication
Diabetes Care, 2012, Vol 35, Issue 5, p965
- ISSN
0149-5992
- Publication type
Article
- DOI
10.2337/dc11-2021