Effect of Continuous Glucose Monitoring on Hypoglycemia in Type 1 Diabetes

OBJECTIVE: To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. RESEARCH DESIGN AND METHODS: In this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglob...

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Vydáno v:	Diabetes care Ročník 34; číslo 4; s. 795 - 800
Hlavní autoři:	Battelino, Tadej, Phillip, Moshe, Bratina, Natasa, Nimri, Revital, Oskarsson, Per, Bolinder, Jan
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States American Diabetes Association 01.04.2011
Témata:	Adolescent Adult adults Aged blood blood glucose Blood Glucose - metabolism Blood Glucose Self-Monitoring Blood sugar Blood sugar monitoring Care and treatment Child children Clinical medicine Design Diabetes Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - metabolism Diabetes Mellitus, Type 1 - physiopathology Diabetes therapy Diabetics diagnosis Female glucose Glycated Hemoglobin Glycated Hemoglobin A - metabolism glycohemoglobin Glycosylated hemoglobin Grants Humans Hypoglycemia Hypoglycemia - diagnosis Hypoglycemia - pathology insulin-dependent diabetes mellitus Male metabolism Middle Aged monitoring Monitoring systems Original Research pathology Patient monitoring equipment patients people physiopathology screening Statistical analysis therapeutics Type 1 diabetes Young Adult
ISSN:	0149-5992, 1935-5548, 1935-5548
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Abstract	OBJECTIVE: To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. RESEARCH DESIGN AND METHODS: In this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin A₁c (HbA₁c) <7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real-time continuous glucose monitoring. The primary outcome was the time spent in hypoglycemia (interstitial glucose concentration <63 mg/dL) over a period of 26 weeks. Analysis was by intention to treat for all randomized patients. RESULTS: The time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group (mean ± SD 0.48 ± 0.57 and 0.97 ± 1.55 h/day, respectively; ratio of means 0.49; 95% CI 0.26-0.76; P = 0.03). HbA₁c at 26 weeks was lower in the continuous monitoring group than in the control group (difference -0.27%; 95% CI -0.47 to -0.07; P = 0.008). Time spent in 70 to 180 mg/dL normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group (mean hours per day, 17.6 vs. 16.0, P = 0.009). CONCLUSIONS: Continuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in HbA₁c in children and adults with type 1 diabetes.
AbstractList	To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. In this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin A^sub 1c^ (HbA^sub 1c^) <7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real-time continuous glucose monitoring. The primary outcome was the time spent in hypoglycemia (interstitial glucose concentration <63 mg/dL) over a period of 26 weeks. Analysis was by intention to treat for all randomized patients. The time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group (mean ± SD 0.48 ± 0.57 and 0.97 ± 1.55 h/day, respectively; ratio of means 0.49; 95% CI 0.26-0.76; P = 0.03). HbA^sub 1c^ at 26 weeks was lower in the continuous monitoring group than in the control group (difference -0.27%; 95% CI -0.47 to -0.07; P = 0.008). Time spent in 70 to 180 mg/dL normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group (mean hours per day, 17.6 vs. 16.0, P = 0.009). Continuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in HbA^sub 1c^ in children and adults with type 1 diabetes. To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes.OBJECTIVETo assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes.In this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin A(1c) (HbA(1c)) <7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real-time continuous glucose monitoring. The primary outcome was the time spent in hypoglycemia (interstitial glucose concentration <63 mg/dL) over a period of 26 weeks. Analysis was by intention to treat for all randomized patients.RESEARCH DESIGN AND METHODSIn this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin A(1c) (HbA(1c)) <7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real-time continuous glucose monitoring. The primary outcome was the time spent in hypoglycemia (interstitial glucose concentration <63 mg/dL) over a period of 26 weeks. Analysis was by intention to treat for all randomized patients.The time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group (mean ± SD 0.48 ± 0.57 and 0.97 ± 1.55 h/day, respectively; ratio of means 0.49; 95% CI 0.26-0.76; P = 0.03). HbA(1c) at 26 weeks was lower in the continuous monitoring group than in the control group (difference -0.27%; 95% CI -0.47 to -0.07; P = 0.008). Time spent in 70 to 180 mg/dL normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group (mean hours per day, 17.6 vs. 16.0, P = 0.009).RESULTSThe time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group (mean ± SD 0.48 ± 0.57 and 0.97 ± 1.55 h/day, respectively; ratio of means 0.49; 95% CI 0.26-0.76; P = 0.03). HbA(1c) at 26 weeks was lower in the continuous monitoring group than in the control group (difference -0.27%; 95% CI -0.47 to -0.07; P = 0.008). Time spent in 70 to 180 mg/dL normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group (mean hours per day, 17.6 vs. 16.0, P = 0.009).Continuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in HbA(1c) in children and adults with type 1 diabetes.CONCLUSIONSContinuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in HbA(1c) in children and adults with type 1 diabetes. OBJECTIVE: To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. RESEARCH DESIGN AND METHODS: In this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin A₁c (HbA₁c) <7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real-time continuous glucose monitoring. The primary outcome was the time spent in hypoglycemia (interstitial glucose concentration <63 mg/dL) over a period of 26 weeks. Analysis was by intention to treat for all randomized patients. RESULTS: The time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group (mean ± SD 0.48 ± 0.57 and 0.97 ± 1.55 h/day, respectively; ratio of means 0.49; 95% CI 0.26-0.76; P = 0.03). HbA₁c at 26 weeks was lower in the continuous monitoring group than in the control group (difference -0.27%; 95% CI -0.47 to -0.07; P = 0.008). Time spent in 70 to 180 mg/dL normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group (mean hours per day, 17.6 vs. 16.0, P = 0.009). CONCLUSIONS: Continuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in HbA₁c in children and adults with type 1 diabetes. To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. In this randomized, controlled, multicenter study, 120 children and adults on intensive therapy for type 1 diabetes and a screening level of glycated hemoglobin A(1c) (HbA(1c)) <7.5% were randomly assigned to a control group performing conventional home monitoring with a blood glucose meter and wearing a masked continuous glucose monitor every second week for five days or to a group with real-time continuous glucose monitoring. The primary outcome was the time spent in hypoglycemia (interstitial glucose concentration <63 mg/dL) over a period of 26 weeks. Analysis was by intention to treat for all randomized patients. The time per day spent in hypoglycemia was significantly shorter in the continuous monitoring group than in the control group (mean ± SD 0.48 ± 0.57 and 0.97 ± 1.55 h/day, respectively; ratio of means 0.49; 95% CI 0.26-0.76; P = 0.03). HbA(1c) at 26 weeks was lower in the continuous monitoring group than in the control group (difference -0.27%; 95% CI -0.47 to -0.07; P = 0.008). Time spent in 70 to 180 mg/dL normoglycemia was significantly longer in the continuous glucose monitoring group compared with the control group (mean hours per day, 17.6 vs. 16.0, P = 0.009). Continuous glucose monitoring was associated with reduced time spent in hypoglycemia and a concomitant decrease in HbA(1c) in children and adults with type 1 diabetes.
Audience	Professional
Author	Nimri, Revital Oskarsson, Per Bolinder, Jan Phillip, Moshe Battelino, Tadej Bratina, Natasa
Author_xml	– sequence: 1 fullname: Battelino, Tadej – sequence: 2 fullname: Phillip, Moshe – sequence: 3 fullname: Bratina, Natasa – sequence: 4 fullname: Nimri, Revital – sequence: 5 fullname: Oskarsson, Per – sequence: 6 fullname: Bolinder, Jan
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/21335621$$D View this record in MEDLINE/PubMed http://kipublications.ki.se/Default.aspx?queryparsed=id:122317691$$DView record from Swedish Publication Index (Karolinska Institutet)
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Snippet	OBJECTIVE: To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. RESEARCH DESIGN AND METHODS: In this... To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. In this randomized, controlled, multicenter study, 120... To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes. In this randomized, controlled, multicenter study, 120... To assess the impact of continuous glucose monitoring on hypoglycemia in people with type 1 diabetes.OBJECTIVETo assess the impact of continuous glucose...
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SubjectTerms	Adolescent Adult adults Aged blood blood glucose Blood Glucose - metabolism Blood Glucose Self-Monitoring Blood sugar Blood sugar monitoring Care and treatment Child children Clinical medicine Design Diabetes Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - metabolism Diabetes Mellitus, Type 1 - physiopathology Diabetes therapy Diabetics diagnosis Female glucose Glycated Hemoglobin Glycated Hemoglobin A - metabolism glycohemoglobin Glycosylated hemoglobin Grants Humans Hypoglycemia Hypoglycemia - diagnosis Hypoglycemia - pathology insulin-dependent diabetes mellitus Male metabolism Middle Aged monitoring Monitoring systems Original Research pathology Patient monitoring equipment patients people physiopathology screening Statistical analysis therapeutics Type 1 diabetes Young Adult
Title	Effect of Continuous Glucose Monitoring on Hypoglycemia in Type 1 Diabetes
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