Real-time continuous glucose monitoring improves glycemic control and reduces hypoglycemia: Real-world data

Prim Care Diabetes. 2022 Dec;16(6):786-790. doi: 10.1016/j.pcd.2022.09.005. Epub 2022 Sep 16.

Abstract

Aim: To study the effect of real time continuous glucose monitor (RT-CGM) use on glycemic parameters in patients with diabetes mellitus (DM) in real world practice.

Methods: We retrospectively studied 91 adult subjects with DM who had been using Dexcom™ RT-CGM. Two consecutive hemoglobin A1c (HbA1c), both prior to and after at least 3 months of RT-CGM initiation, were collected. A total of 31 subjects completed a 5-14 day user blinded CGM using a Freestyle Libre™ prior to RT-CGM initiation. The first two week period following at least 3 months use of RT-CGM was analyzed for CGM metrics.

Results: A total of 51.6 % of subjects had T1DM, 34.1 % used continuous subcutaneous insulin infusion (CSII), and 62.6 % had DM for > 10 years. Both HbA1c obtained following RT-CGM initiation decreased significantly compared to baseline (8.11 + 1.47% vs 7.69 + 1.25 %; P = 0.002 & 8.16 + 1.51 % vs 7.62 + 1.06 %; P = 0.001). Subjects with baseline HbA1c > 7.0 % showed even more robust reduction in both HbA1c after RT-CGM initiation (8.74 + 1.24 % vs 7.99 + 1.22 %; P = 0.000 & 8.74 + 1.32 % vs 7.85 + 1.07 %; P = 0.001). On comparison of CGM metrics, there was a significant reduction in time spent in hypoglycemia (sugars < 70 mg/dl) including severe hypoglycemia (sugars < 54 mg/dl) after initiation of the RT-CGM (9.16 + 8.68 % vs 1.29 + 2.21 %; P = <0.001 & 4.58 + 5.43 % vs 0.28 + 0.58 %; P = <0.001). CoV of glucose was also decreased significantly (39.61 + 9.36 % vs 31.06 + 6.74 %; P = <0.001) with RT- CGM use.

Conclusion: RT-CGM use for at least 3 months in patients with DM results in meaningful HbA1c reductions with stable glycemic control without increasing the risk of hypoglycemia.

Keywords: CGM; Continuous Glucose Monitoring; Dexcom; Diabetes; Glucose coefficient of variation; HbA1c; Hypoglycemia.

MeSH terms

  • Adult
  • Blood Glucose
  • Blood Glucose Self-Monitoring / methods
  • Diabetes Mellitus, Type 1* / diagnosis
  • Diabetes Mellitus, Type 1* / drug therapy
  • Glucose
  • Glycated Hemoglobin / analysis
  • Glycemic Control / adverse effects
  • Humans
  • Hypoglycemia* / chemically induced
  • Hypoglycemia* / diagnosis
  • Hypoglycemia* / prevention & control
  • Hypoglycemic Agents / adverse effects
  • Insulin / adverse effects
  • Retrospective Studies

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • Glucose