OBJECTIVE The aim of this trial was to compare the efficacy of real-time and intermittently scanned continuous glucose monitoring (rtCGM and isCGM, respectively) in maintaining optimal glycemic control. RESEARCH DESIGN AND METHODS In this randomized study, adults with type 1 diabetes (T1D) and normal hypoglycemia awareness (Gold score <4) used rtCGM (Guardian Connect Mobile) or isCGM (FreeStyle Libre) during 4 days of physical activity (exercise phase) and in the subsequent 4 weeks at home (home phase). Primary end points were time in hypoglycemia (<3.9 mmol/L [<70 mg/dL]) and time in range (3.9–10.0 mmol/L [70–180 mg/dL]). The isCGM group wore an additional masked Enlite sensor (iPro2) for 6 days to check for bias between the different sensors used by the rtCGM and isCGM systems. RESULTS Sixty adults with T1D (mean age 38 ± 13 years; A1C 62 ± 12 mmol/mol [7.8 ± 1.1%]) were randomized to rtCGM ( n = 30) or isCGM ( n = 30). All participants completed the study. Percentage of time in hypoglycemia (<3.9 mmol/L [<70 mg/dL]) was lower among rtCGM versus isCGM participants in the exercise phase (6.8 ± 5.5% vs. 11.4 ± 8.6%, respectively; P = 0.018) and during the home phase (5.3 ± 2.5% vs. 7.3 ± 4.4%, respectively; P = 0.035). Hypoglycemia differences were significant and most notable during the night. rtCGM participants spent more time in range (3.9–10 mmol/L [70–180 mg/dL]) than isCGM participants throughout both the exercise (78.5 ± 10.2% vs. 69.7 ± 16%, respectively; P = 0.0149) and home (75.6 ± 9.7% vs. 67.4 ± 17.8%, respectively; P = 0.0339) phases. The results were robust to the insignificant bias between rtCGM and isCGM sensors that masked CGM found in the isCGM arm. CONCLUSIONS rtCGM was superior to isCGM in reducing hypoglycemia and improving time in range in adults with T1D with normal hypoglycemia awareness, demonstrating the value of rtCGM alarms during exercise and in daily diabetes self-management.
Background: The aim of this trial was to compare the efficacy of real-time and <a>intermittently-scanned </a>continuous glucose monitoring (rtCGM and isCGM, respectively) in maintaining optimal glycemic control. <p>Methods: <a>In this randomized study, adults with T1D and normal hypoglycemia</a><b> </b>awareness (GOLD score <4) used rtCGM (Guardian Connect Mobile) or isCGM (Freestyle Libre) during 4 days of physical activity (exercise phase) and in subsequent 4 weeks at home (home phase). Primary endpoints were time in hypoglycemia (<3.9 mmol/l [<70 mg/dl]) and time in range (3.9-10.0 mmol/l [70-180 mg/dl]). The isCGM group wore an additional masked Enlite sensor (iPro2) for 6 days to check for bias between the different sensors used by the rtCGM and isCGM systems.<b></b></p> <p>Results: Sixty adults with T1D (mean age 38±13 years, A1C 62±12 mmol/mol [7.8±1.1%]) were randomized to rtCGM (n=30) or isCGM (n=30). All participants completed the study. Percentage of time in hypoglycemia (<3.9 mmol/l [<70 mg/dl)) was lower among rtCGM vs. isCGM participants in the exercise phase (6.8±5.5% vs. 11.4±8.6%, respectively; p=0.018) and during the home phase (5.3±2.5% vs. 7.3±4.4%, respectively; p=0.035). Hypoglycemia differences were significant and most notable during the night. rtCGM participants spent more time in range (3.9-10 mmol/l [70-180 mg/dl]) than isCGM participants throughout both the exercise (78.5±10.2% vs. 69.7±16%, respectively; p=0.0149) and home (75.6±9.7% vs. 67.4±17.8%, respectively; p=0.0339) phases. The results were robust to the insignificant bias between rtCGM and isCGM sensors that masked CGM found in the isCGM arm.<a></a></p> <p>Conclusion: rtCGM was superior to isCGM in reducing hypoglycemia and improving time in range in T1D adults with normal hypoglycemia awareness, demonstrating the value of rtCGM alarms during exercise and in daily diabetes self-management.</p> <br>
Background: The aim of this trial was to compare the efficacy of real-time and <a>intermittently-scanned </a>continuous glucose monitoring (rtCGM and isCGM, respectively) in maintaining optimal glycemic control. <p>Methods: <a>In this randomized study, adults with T1D and normal hypoglycemia</a><b> </b>awareness (GOLD score <4) used rtCGM (Guardian Connect Mobile) or isCGM (Freestyle Libre) during 4 days of physical activity (exercise phase) and in subsequent 4 weeks at home (home phase). Primary endpoints were time in hypoglycemia (<3.9 mmol/l [<70 mg/dl]) and time in range (3.9-10.0 mmol/l [70-180 mg/dl]). The isCGM group wore an additional masked Enlite sensor (iPro2) for 6 days to check for bias between the different sensors used by the rtCGM and isCGM systems.<b></b></p> <p>Results: Sixty adults with T1D (mean age 38±13 years, A1C 62±12 mmol/mol [7.8±1.1%]) were randomized to rtCGM (n=30) or isCGM (n=30). All participants completed the study. Percentage of time in hypoglycemia (<3.9 mmol/l [<70 mg/dl)) was lower among rtCGM vs. isCGM participants in the exercise phase (6.8±5.5% vs. 11.4±8.6%, respectively; p=0.018) and during the home phase (5.3±2.5% vs. 7.3±4.4%, respectively; p=0.035). Hypoglycemia differences were significant and most notable during the night. rtCGM participants spent more time in range (3.9-10 mmol/l [70-180 mg/dl]) than isCGM participants throughout both the exercise (78.5±10.2% vs. 69.7±16%, respectively; p=0.0149) and home (75.6±9.7% vs. 67.4±17.8%, respectively; p=0.0339) phases. The results were robust to the insignificant bias between rtCGM and isCGM sensors that masked CGM found in the isCGM arm.<a></a></p> <p>Conclusion: rtCGM was superior to isCGM in reducing hypoglycemia and improving time in range in T1D adults with normal hypoglycemia awareness, demonstrating the value of rtCGM alarms during exercise and in daily diabetes self-management.</p> <br>
Telemedicína se rozvíjí v posledních dekádách 20. století a je založena na přenosu zvuku, obrazu a dat stále častěji za využití bezdrátových technologií. V obezitologii se objevuje v praxi od konce 20. století, kdy došlo nejen k rozvoji komunikačních technologií a objevily se první záznamy příjmu potravy přes počítačový software, ale především k velkému nárůstu počtu obézních pacientů. V České republice je v současné době více jak 60 % dospělé populace s diagnózou nadváhy nebo obezity. Telemedicína se uplatňuje především při sběru dat o energetickém příjmu, monitoringu pohybové aktivity, záznamu hladin glykémií a komunikaci mezi terapeutem a pacientem. Využití telemedicíny zvyšuje compliance i adherenci obézních pacientů k léčbě a zvyšuje také jejich motivaci. Telemedicína s možností uchovávání dat, sdílení dat a jejich analýzou je tak postupem, jak snížit náklady na diagnostiku a léčbu obezity.
3. interní klinika -klinika endokrinologie a metabolismu 1. LF UK a VFN Praha 2 FTVS Praha -Katedra zdravotní TV a tělovýchovného lékařství, Praha 3 3. klinika rehabilitačního lékařství 1. LF UK a VFN Praha 4 ORP centrum, Praha Fyzická aktivita je nedílnou součástí léčby obezity. Až překvapivě i mezi zdravotníky přetrvává hodnocení léčby obezity pouze na základě hmotnostního poklesu. Léčba obezity není však jen prosté snižování hmotnosti, ale především léčba přidružených onemocnění, jako hypertenze, diabetes, dyslipidemie apod. Jen velmi zřídka je hodnocena fyzická zdatnost, ačkoliv ta nejlépe predikuje budoucnost a snižuje mortalitu ze všech příčin. Jedná se především o kardiovaskulární onemocnění, kde se ukazuje, že parametr VO 2Max je nejsilnějším prediktorem nejen kardiovaskulární mortality. Specifika preskripce fyzické aktivity pak s sebou přináší přítomnost nejen diabetu, hypertenze a kardiovaskulárních onemocnění, ale i artrózy nosných kloubů, event. absolvování bariatrické operace. K objektivizaci fyzické aktivity včetně subjektivních příznaků je vhodné využít moderních metod telemedicíny, která je tak budoucností při léčbě nejen obezity.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.