Continuous glucose monitoring (CGM) is associated with reduced time and episodes in both nocturnal and daytime hypoglycemia and improved hypoglycemia-related confidence in individuals with type 1 diabetes treated with multiple daily insulin injections, according to a randomized clinical trial published in Diabetes Technology & Therapeutics.
The 69-week, open-label, multicenter, randomized clinical trial compared CGM with self-measurement of blood glucose in 161 participants with type 1 diabetes that were being treated with multiple daily insulin injections. Evaluations used the masked CGM and hypoglycemia confidence questionnaire and were performed from the GOLD randomized trial.
From February to December 2014, participants’ glucose values were continually monitored at regular intervals throughout the day, with this information made available to them. This made it possible for them to take early preventative actions and prevent hypoglycemic episodes, in some instances. Results at the end of the clinical trial showed the proportion of daily time with hypoglycemia was less with CGM than with conventional therapy (P <.001). For daytime hypoglycemia, glucose levels were significantly reduced by CGM as compared with self-measurement of blood glucose (P <.001).
CGM also showed marked improvement in hypoglycemia-related confidence in social situations compared with self-measurement of blood glucose (P =.016). The ability to take preventive action and avoid serious problems as a result of hypoglycemia also showed increased confidence in these participants (P =.002). During the evaluation, participants also reported greater confidence in avoiding hypoglycemia during CGM use (P =.0033) and continue to partake with one’s chosen lifestyle activities (P =.022).
The results support the use of CGM to promote greater well-being and quality of life for adults affected by type I diabetes treated with multiple daily insulin injections. Because participants were aware of intervention throughout the study, their elevated levels of confidence in detecting and responding to decreasing blood glucose levels may be a result of continuous information being made available to them; however, the reduction in nocturnal and daytime hypoglycemia and number of hypoglycemic episodes with the use of CGM remains clinically significant.
Ólafsdóttir AF, Polonsky W, Bolinder J, et al. A randomized clinical trial of the effect of continuous glucose monitoring on nocturnal hypoglycemia, daytime hypoglycemia, glycemic variability, and hypoglycemia confidence in persons with type 1 diabetes treated with multiple daily insulin injections (GOLD-3). Diabetes Technol Ther. 2018; 20(4):274-284.