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Efficacy of real‐time continuous glucose monitoring on glycaemic control and glucose variability in type 1 diabetic patients treated with either insulin pumps or multiple insulin injection therapy: a randomized controlled crossover trial
Author(s) -
Tumminia Andrea,
Crimi Salvatore,
Sciacca Laura,
Buscema Massimo,
Frittitta Lucia,
Squatrito Sebastiano,
Vigneri Riccardo,
Tomaselli Letizia
Publication year - 2015
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.2557
Subject(s) - continuous glucose monitoring , insulin pump , medicine , insulin , crossover study , type 1 diabetes , randomized controlled trial , diabetes mellitus , endocrinology , glycemic , placebo , alternative medicine , pathology
Background The aim of this study was to determine the efficacy of real‐time continuous glucose monitoring in T1D patients treated with insulin pump therapy or multiple daily insulin therapy. Methods Twenty adult patients (ten insulin pump therapy and ten multiple daily insulin) with poor glycaemic control (HbA 1c > 8.0%) were randomized into two groups for 6 months: the continuous glucose monitoring arm (using real‐time continuous glucose monitoring) and the SMBG arm. After 2 months of wash‐out, the participants crossed over. The primary outcome was HbA 1c reduction. The secondary outcomes were hypoglycaemia and hyperglycaemia risk assessment (area under the curve < 70 mg/dL/day and AUC > 200 mg/dL/day, respectively) and glucose variability. Results Fourteen patients (eight multiple daily insulin, six insulin pump therapy) used continuous glucose monitoring appropriately (at least 40% of the time). In these patients, the improvement in glycaemic control was more evident during the real‐time continuous glucose monitoring period (7.76% ± 0.4 vs 8.54% ± 0.4, p < 0.05) than during the self‐monitoring of blood glucose period (8.42% ± 0.4 vs 8.56% ± 0.5, p = 0.2). Better results with continuous glucose monitoring were observed in patients using multiple daily insulin with greater improvement in both glycaemic control (7.71% ± 0.2 vs 8.58% ± 0.2, p < 0.05) and glucose variability and with a marked reduction in the risk of both hypoglycaemia and hyperglycaemia. Conclusions Appropriate use of real‐time continuous glucose monitoring improved glycometabolic control in T1D patients. The effects of continuous glucose monitoring were more evident in patients under multiple daily insulin treatment, compared with insulin pump therapy. Glucose variability, in addition to glycaemic control, was improved in compliant diabetic patients. Copyright © 2014 John Wiley & Sons, Ltd.