| Reference : The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with... |
| Scientific journals : Article | |||
| Human health sciences : Multidisciplinary, general & others | |||
| http://hdl.handle.net/10993/26967 | |||
| The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial | |
| English | |
| Battelino, T. [] | |
| Conget, I. [] | |
| Olsen, B. [] | |
| Schütz-Fuhrmann, I. [] | |
| Hommel, E. [] | |
| Hoogma, R. [] | |
| Schierloh, U. [] | |
| Sulli, N. [] | |
| Bolinder, J. [] | |
De Beaufort, Carine  [University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > >] | |
| Dec-2012 | |
| Diabetologia | |
| Springer Verlag | |
| 55 | |
| 12 | |
| 3155-3162 | |
| Yes (verified by ORBilu) | |
| 0012-186X | |
| 1432-0428 | |
| Berlin | |
| Germany | |
| [en] continuous glucose monitoring ; diabetes mellitus type 1 ; glycaemic control ; insulin pump therapy ; randomised controlled trial ; sensor-augmented insulin pump therapy | |
| [en] Aims/hypothesis
The aim of this multicentre, randomised, controlled crossover study was to determine the efficacy of adding continuous glucose monitoring (CGM) to insulin pump therapy (CSII) in type 1 diabetes. Methods Children and adults (n = 153) on CSII with HbA1c 7.5–9.5% (58.5–80.3 mmol/mol) were randomised to (CGM) a Sensor On or Sensor Off arm for 6 months. After 4 months’ washout, participants crossed over to the other arm for 6 months. Paediatric and adult participants were separately electronically randomised through the case report form according to a predefined randomisation sequence in eight secondary and tertiary centres. The primary outcome was the difference in HbA1c levels between arms after 6 months. Results Seventy-seven participants were randomised to the On/Off sequence and 76 to the Off/On sequence; all were included in the primary analysis. The mean difference in HbA1c was –0.43% (–4.74 mmol/mol) in favour of the Sensor On arm (8.04% [64.34 mmol/mol] vs 8.47% [69.08 mmol/mol]; 95% CI −0.32%, −0.55% [−3.50, −6.01 mmol/mol]; p < 0.001). Following cessation of glucose sensing, HbA1c reverted to baseline levels. Less time was spent with sensor glucose <3.9 mmol/l during the Sensor On arm than in the Sensor Off arm (19 vs 31 min/day; p = 0.009). The mean number of daily boluses increased in the Sensor On arm (6.8 ± 2.5 vs 5.8 ± 1.9, p < 0.0001), together with the frequency of use of the temporary basal rate (0.75 ± 1.11 vs 0.26 ± 0.47, p < 0.0001) and manual insulin suspend (0.91 ± 1.25 vs 0.70 ± 0.75, p < 0.018) functions. Four vs two events of severe hypoglycaemia occurred in the Sensor On and Sensor Off arm, respectively (p = 0.40). Conclusions/interpretation Continuous glucose monitoring was associated with decreased HbA1c levels and time spent in hypoglycaemia in individuals with type 1 diabetes using CSII. More frequent self-adjustments of insulin therapy may have contributed to these effects. | |
| SWITCH study group | |
| http://hdl.handle.net/10993/26967 |
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