Premium
Combined continuous glucose monitoring and subcutaneous insulin infusion versus self‐monitoring of blood glucose with optimized multiple injections in people with type 1 diabetes: A randomized crossover trial
Author(s) -
Dicembrini Ilaria,
Pala Laura,
Caliri Mariasmeralda,
Minardi Silvia,
Cosentino Claudia,
Monami Matteo,
Mannucci Edoardo
Publication year - 2020
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.14028
Subject(s) - medicine , crossover study , randomized controlled trial , continuous glucose monitoring , glycated haemoglobin , type 1 diabetes , regimen , diabetes mellitus , bolus (digestion) , type 2 diabetes , blood glucose self monitoring , insulin , insulin pump , placebo , endocrinology , alternative medicine , pathology
Aim To investigate the efficacy of a combination of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) versus an optimized degludec‐based multiple daily injections (MDI) regimen + self‐monitoring of blood glucose (SMBG) in people with type 1 diabetes with regard to optimizing glucose control. Material and methods The trial included 28 individuals who underwent a 4‐week run‐in phase, and were then randomized 1:1 to: (a) CSII + CGM followed by MDI + SMBG or (b) an MDI basal‐bolus regimen followed by CSII + CGM. Results In patients randomized to the CSII + CGM → MDI + SMBG arm, a significant reduction in glycated haemoglobin (HbA1c) versus baseline was found at the end of the first phase (CSII + CGM) without significant variation in the following MDI + SMBG phase. In the arm randomized to the MDI + SMBG → CSII + CGM sequence, a significant improvement in HbA1c was observed in the first phase (MDI + SMBG), together with a further decrease in the following CSII + CGM phase. In the comparison of the two treatments using a mixed linear model, CSII + CGM was superior to MDI + SMBG with respect to change in HbA1c ( P = 0.001). Conclusions This study suggests that CSII + CGM improves glycaemic control without relevant safety issues in type 1 diabetes, in comparison with MDI + SMBG.