Kellee M Miller1, Lauren G Kanapka1, Michael R Rickels2, Andrew J Ahmann3, Grazia Aleppo4, Lynn Ang5, Anuj Bhargava6, Bruce W Bode7, Anders Carlson8, Naomi S Chaytor9, Gail Gannon10, Robin Goland11, Irl B Hirsch12, Lisa Kiblinger7, Davida Kruger13, Yogish C Kudva14, Carol J Levy15, Janet B McGill16, Grenye O'Malley15, Anne L Peters17, Louis H Philipson10, Athena Philis-Tsimikas18, Rodica Pop-Busui5, Maamoun Salam16, Viral N Shah19, Michael J Thompson20, Francesco Vendrame21, Alandra Verdejo1, Ruth S Weinstock22, Laura Young23, Richard Pratley24. 1. Jaeb Center for Health Research, Tampa, Florida, USA. 2. Rodebaugh Diabetes Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 3. Division of Endocrinology, Diabetes, and Clinical Nutrition, Oregon Health and Science University, Portland, Oregon, USA. 4. Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. 5. Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA. 6. Iowa Diabetes and Endocrinology Research Center, Des Moines, Iowa, USA. 7. Formally Atlanta Diabetes Associates, Atlanta, Georgia, USA. 8. Park Nicollet International Diabetes Center, Minneapolis, Minnesota, USA. 9. Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA. 10. Kovler Diabetes Center, University of Chicago, Chicago, Illinois, USA. 11. Naomi Berri Diabetes Center, Columbia University, New York, New York, USA. 12. Division of Metabolism, Endocrinology and Nutrition, University of Washington, Seattle, Washington, USA. 13. Henry Ford Health System, Detroit, Michigan, USA. 14. Mayo Clinic, Rochester, Minnesota, USA. 15. Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA. 16. Division of Endocrinology, Metabolism & Lipid Research, John T. Milliken Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri, USA. 17. Department of Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA. 18. Scripps Whittier Diabetes Institute, La Jolla, California, USA. 19. Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 20. Department of Endocrinology-Diabetes, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 21. Division of Endocrinology, Diabetes, and Metabolism at the University of Miami School of Medicine, University of Miami, Miami, Florida, USA. 22. Department of Medicine, SUNY Upstate Medical University, Syracuse, New York, USA. 23. Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA. 24. AdventHealth Translation Research Institute, Orlando, Florida, USA.
Abstract
Objective: To evaluate glycemic outcomes in the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) participants during an observational extension phase. Research Design and Methods: WISDM RCT was a 26-week RCT comparing continuous glucose monitoring (CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes. Of the 198 participants who completed the RCT, 100 (98%) CGM group participants continued CGM (CGM-CGM cohort) and 94 (98%) BGM group participants initiated CGM (BGM-CGM cohort) for an additional 26 weeks. Results: CGM was used a median of >90% of the time at 52 weeks in both cohorts. In the CGM-CGM cohort, median time <70 mg/dL decreased from 5.0% at baseline to 2.6% at 26 weeks and remained stable with a median of 2.8% at 52 weeks (P < 0.001 baseline to 52 weeks). Participants spent more time in range 70-180 mg/dL (TIR) (mean 56% vs. 64%; P < 0.001) and had lower hemoglobin A1c (HbA1c) (mean 7.6% [59 mmol/mol] vs. 7.4% [57 mmol/mol]; P = 0.01) from baseline to 52 weeks. In BGM-CGM, from 26 to 52 weeks median time <70 mg/dL decreased from 3.9% to 1.9% (P < 0.001), TIR increased from 56% to 60% (P = 0.006) and HbA1c decreased from 7.5% (58 mmol/mol) to 7.3% (57 mmol/mol) (P = 0.025). In BGM-CGM, a severe hypoglycemic event was reported for nine participants while using BGM during the RCT and for two participants during the extension phase with CGM (P = 0.02). Conclusions: CGM use reduced hypoglycemia without increasing hyperglycemia in older adults with type 1 diabetes. These data provide further evidence for fully integrating CGM into clinical practice. Clinicaltrials.gov (NCT03240432).
Objective: To evaluate glycemic outcomes in the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) participants during an observational extension phase. Research Design and Methods: WISDM RCT was a 26-week RCT comparing continuous glucose monitoring (CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes. Of the 198 participants who completed the RCT, 100 (98%) CGM group participants continued CGM (CGM-CGM cohort) and 94 (98%) BGM group participants initiated CGM (BGM-CGM cohort) for an additional 26 weeks. Results: CGM was used a median of >90% of the time at 52 weeks in both cohorts. In the CGM-CGM cohort, median time <70 mg/dL decreased from 5.0% at baseline to 2.6% at 26 weeks and remained stable with a median of 2.8% at 52 weeks (P < 0.001 baseline to 52 weeks). Participants spent more time in range 70-180 mg/dL (TIR) (mean 56% vs. 64%; P < 0.001) and had lower hemoglobin A1c (HbA1c) (mean 7.6% [59 mmol/mol] vs. 7.4% [57 mmol/mol]; P = 0.01) from baseline to 52 weeks. In BGM-CGM, from 26 to 52 weeks median time <70 mg/dL decreased from 3.9% to 1.9% (P < 0.001), TIR increased from 56% to 60% (P = 0.006) and HbA1c decreased from 7.5% (58 mmol/mol) to 7.3% (57 mmol/mol) (P = 0.025). In BGM-CGM, a severe hypoglycemic event was reported for nine participants while using BGM during the RCT and for two participants during the extension phase with CGM (P = 0.02). Conclusions: CGM use reduced hypoglycemia without increasing hyperglycemia in older adults with type 1 diabetes. These data provide further evidence for fully integrating CGM into clinical practice. Clinicaltrials.gov (NCT03240432).
Authors: Sybil A McAuley; Steven Trawley; Sara Vogrin; Glenn M Ward; Spiros Fourlanos; Charlotte A Grills; Melissa H Lee; Andisheh Mohammad Alipoor; David N O'Neal; Niamh A O'Regan; Vijaya Sundararajan; Peter G Colman; Richard J MacIsaac Journal: Diabetes Care Date: 2022-02-01 Impact factor: 19.112
Authors: Richard E Pratley; Lauren G Kanapka; Michael R Rickels; Andrew Ahmann; Grazia Aleppo; Roy Beck; Anuj Bhargava; Bruce W Bode; Anders Carlson; Naomi S Chaytor; D Steven Fox; Robin Goland; Irl B Hirsch; Davida Kruger; Yogish C Kudva; Carol Levy; Janet B McGill; Anne Peters; Louis Philipson; Athena Philis-Tsimikas; Rodica Pop-Busui; Viral N Shah; Michael Thompson; Francesco Vendrame; Alandra Verdejo; Ruth S Weinstock; Laura Young; Kellee M Miller Journal: JAMA Date: 2020-06-16 Impact factor: 56.272
Authors: Kasia J Lipska; Joseph S Ross; Yun Wang; Silvio E Inzucchi; Karl Minges; Andrew J Karter; Elbert S Huang; Mayur M Desai; Thomas M Gill; Harlan M Krumholz Journal: JAMA Intern Med Date: 2014-07 Impact factor: 21.873
Authors: Tadej Battelino; Thomas Danne; Richard M Bergenstal; Stephanie A Amiel; Roy Beck; Torben Biester; Emanuele Bosi; Bruce A Buckingham; William T Cefalu; Kelly L Close; Claudio Cobelli; Eyal Dassau; J Hans DeVries; Kim C Donaghue; Klemen Dovc; Francis J Doyle; Satish Garg; George Grunberger; Simon Heller; Lutz Heinemann; Irl B Hirsch; Roman Hovorka; Weiping Jia; Olga Kordonouri; Boris Kovatchev; Aaron Kowalski; Lori Laffel; Brian Levine; Alexander Mayorov; Chantal Mathieu; Helen R Murphy; Revital Nimri; Kirsten Nørgaard; Christopher G Parkin; Eric Renard; David Rodbard; Banshi Saboo; Desmond Schatz; Keaton Stoner; Tatsuiko Urakami; Stuart A Weinzimer; Moshe Phillip Journal: Diabetes Care Date: 2019-06-08 Impact factor: 19.112
Authors: Thomas Danne; Revital Nimri; Tadej Battelino; Richard M Bergenstal; Kelly L Close; J Hans DeVries; Satish Garg; Lutz Heinemann; Irl Hirsch; Stephanie A Amiel; Roy Beck; Emanuele Bosi; Bruce Buckingham; Claudio Cobelli; Eyal Dassau; Francis J Doyle; Simon Heller; Roman Hovorka; Weiping Jia; Tim Jones; Olga Kordonouri; Boris Kovatchev; Aaron Kowalski; Lori Laffel; David Maahs; Helen R Murphy; Kirsten Nørgaard; Christopher G Parkin; Eric Renard; Banshi Saboo; Mauro Scharf; William V Tamborlane; Stuart A Weinzimer; Moshe Phillip Journal: Diabetes Care Date: 2017-12 Impact factor: 19.112