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- Title
The effect of continuous glucose monitoring in well-controlled type 1 diabetes.
- Authors
Beck, Roy W; Hirsch, Irl B; Laffel, Lori; Tamborlane, William V; Bode, Bruce W; Buckingham, Bruce; Chase, Peter; Clemons, Robert; Fiallo-Scharer, Rosanna; Fox, Larry A; Gilliam, Lisa K; Huang, Elbert S; Kollman, Craig; Kowalski, Aaron J; Lawrence, Jean M; Lee, Joyce; Mauras, Nelly; O'Grady, Michael; Ruedy, Katrina J; Tansey, Michael; Tsalikian, Eva; Weinzimer, Stuart A; Wilson, Darrell M; Wolpert, Howard; Wysocki, Tim; Xing, Dongyuan; Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group
- 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%.
- Publication
Diabetes care, 2009, Vol 32, Issue 8, p1378
- ISSN
1935-5548
- Publication type
Journal Article
- DOI
10.2337/dc09-0108