Sara E Boucher1, Andrew R Gray2, Esko J Wiltshire3,4, Martin I de Bock5, Barbara C Galland1, Paul A Tomlinson1, Jenny A Rayns6, Karen E MacKenzie5, Huan Chan7, Shelley Rose1, Benjamin J Wheeler8,9. 1. Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. 2. Centre for Biostatistics, Division of Health Sciences, University of Otago, Dunedin, New Zealand. 3. Department of Paediatrics and Child Health, University of Otago, Wellington, Wellington, New Zealand. 4. Capital & Coast District Health Board, Wellington, New Zealand. 5. Paediatric Department, Canterbury District Health Board, Christchurch, New Zealand. 6. Endocrinology Department, Southern District Health Board, Dunedin, New Zealand. 7. Department of Endocrinology and General Medicine, Canterbury District Health Board, Christchurch, New Zealand. 8. Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand ben.wheeler@otago.ac.nz. 9. Paediatric Department, Southern District Health Board, Dunedin, New Zealand.
Abstract
OBJECTIVE: To investigate whether intermittently scanned continuous glucose monitoring (isCGM) significantly improves glycemic control compared with capillary self-monitored blood glucose (SMBG) in youth with type 1 diabetes and high-risk glycemic control. RESEARCH DESIGN AND METHODS: This multicenter 6-month randomized, controlled, parallel-arm trial included 64 participants aged 13-20 years with established type 1 diabetes and glycated hemoglobin (HbA1c) ≥9% (≥75 mmol/mol). Participants were allocated to 6-month intervention (isCGM; FreeStyle Libre; Abbott Diabetes Care, Witney, U.K.) (n = 33) or control (SMBG; n = 31) using minimization. The primary outcome was the difference in change in HbA1c from baseline to 6 months. RESULTS: There was no evidence of a difference between groups for changes in HbA1c at 6 months (adjusted mean 0.2% greater improvement for isCGM [95% CI -0.9 to 0.5] [-2.1 mmol/mol (95% CI -9.6 to 5.4)]; P = 0.576). However, glucose-monitoring frequency was 2.83 (95% CI 1.72-4.65; P < 0.001) times higher in the isCGM group compared with that in the SMBG group at 6 months. The change in the Diabetes Treatment Satisfaction Questionnaire mean item score also favored isCGM at 6 months (P = 0.048), with no significant differences between groups for fear of hypoglycemia and quality of life (both general and diabetes specific) (all P > 0.1). CONCLUSIONS: For youth with high-risk glycemic control, isCGM led to improvements in glucose testing frequency and diabetes treatment satisfaction. However, these did not translate to greater improvement in glycemic control over usual care with SMBG at 6 months.
OBJECTIVE: To investigate whether intermittently scanned continuous glucose monitoring (isCGM) significantly improves glycemic control compared with capillary self-monitored blood glucose (SMBG) in youth with type 1 diabetes and high-risk glycemic control. RESEARCH DESIGN AND METHODS: This multicenter 6-month randomized, controlled, parallel-arm trial included 64 participants aged 13-20 years with established type 1 diabetes and glycated hemoglobin (HbA1c) ≥9% (≥75 mmol/mol). Participants were allocated to 6-month intervention (isCGM; FreeStyle Libre; Abbott Diabetes Care, Witney, U.K.) (n = 33) or control (SMBG; n = 31) using minimization. The primary outcome was the difference in change in HbA1c from baseline to 6 months. RESULTS: There was no evidence of a difference between groups for changes in HbA1c at 6 months (adjusted mean 0.2% greater improvement for isCGM [95% CI -0.9 to 0.5] [-2.1 mmol/mol (95% CI -9.6 to 5.4)]; P = 0.576). However, glucose-monitoring frequency was 2.83 (95% CI 1.72-4.65; P < 0.001) times higher in the isCGM group compared with that in the SMBG group at 6 months. The change in the Diabetes Treatment Satisfaction Questionnaire mean item score also favored isCGM at 6 months (P = 0.048), with no significant differences between groups for fear of hypoglycemia and quality of life (both general and diabetes specific) (all P > 0.1). CONCLUSIONS: For youth with high-risk glycemic control, isCGM led to improvements in glucose testing frequency and diabetes treatment satisfaction. However, these did not translate to greater improvement in glycemic control over usual care with SMBG at 6 months.
Authors: Sara Styles; Ben Wheeler; Alisa Boucsein; Hamish Crocket; Michel de Lange; Dana Signal; Esko Wiltshire; Vicki Cunningham; Anita Lala; Wayne Cutfield; Martin de Bock; Anna Serlachius; Craig Jefferies Journal: J Diabetes Metab Disord Date: 2021-10-05
Authors: Mona Elbalshy; Jillian Haszard; Hazel Smith; Sarahmarie Kuroko; Barbara Galland; Nick Oliver; Viral Shah; Martin I de Bock; Benjamin J Wheeler Journal: Diabet Med Date: 2022-04-25 Impact factor: 4.213