This study assessed the clinical impact of four treatment strategies in adults with type 1 diabetes (T1D): real-time continuous glucose monitoring (rtCGM) with multiple daily insulin injections (rtCGM1MDI), rtCGM with continuous subcutaneous insulin infusion (rtCGM1CSII), self-monitoring of blood glucose with MDI (SMBG1MDI), and SMBG with CSII (SMBG1CSII). RESEARCH DESIGN AND METHODS This 3-year, nonrandomized, prospective, real-world, clinical trial followed 94 participants with T1D (rtCGM1MDI, n 5 22; rtCGM1CSII, n 5 26; SMBG1MDI, n 5 21; SMBG1CSII, n 5 25). The main end points were changes in A1C, time in range (70-180 mg/dL [3.9-10 mmol/L]), time below range (<70 mg/dL [<3.9 mmol/L]), glycemic variability, and incidence of hypoglycemia. RESULTS At 3 years, the rtCGM groups (rtCGM1MDI and rtCGM1CSII) had significantly lower A1C (7.0% [53 mmol/mol], P 5 0.0002, and 6.9% [52 mmol/mol], P < 0.0001, respectively), compared with the SMBG1CSII and SMBG1MDI groups (7.7% [61 mmol/mol], P 5 0.3574, and 8.0% [64 mmol/mol], P 5 1.000, respectively), with no significant difference between the rtCGM groups. Significant improvements in percentage of time in range were observed in the rtCGM subgroups (rtCGM1MDI, 48.7-69.0%, P < 0.0001; and rtCGM1CSII, 50.9-72.3%, P < 0.0001) and in the SMBG1CSII group (50.6-57.8%, P 5 0.0114). Significant reductions in time below range were found only in the rtCGM subgroups (rtCGM1MDI, 9.4-5.5%, P 5 0.0387; and rtCGM1CSII, 9.0-5.3%, P 5 0.0235). Seven severe hypoglycemia episodes occurred: SMBG groups, n 5 5; sensor-augmented insulin regimen groups, n 5 2. CONCLUSIONS rtCGM was superior to SMBG in reducing A1C, hypoglycemia, and other end points in individuals with T1D regardless of their insulin delivery method. rtCGM1MDI can be considered an equivalent but lower-cost alternative to sensor-augmented insulin pump therapy and superior to treatment with SMBG1MDI or SMBG1CSII therapy.

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BackgroundThere is an increasing body of evidence suggesting that vitamin D is involved in ethiopathogenesis of obesity and therefore the aim of the study was to investigate whether 5 selected SNPs in VDR (vitamin D receptor) gene are associated also with anthropometry in the obese and non-obese Central-European population.MethodsA total of 882 Central European Caucasian individuals of Czech origin were recruited (n = 882, 232 M/650 F) and weight, height, BMI, lean body mass, fat mass, body fat, waist and hip circumference, waist–hip ratio (WHR) and skinfold thickness were measured. Univariate and multivariate models were constructed in order to investigate the relationship between anthropometry and VDR polymorphisms.ResultsIn the univariate modeling, the CC genotype of FokI SNP was associated with reduced waist circumference (β = −3.48; 95%CI:-7.11;0.15; p = 0.060), sum of skin fold thickness (β = −6.53, 95% CI: -12.96;-0.11; p = 0.046) as well as total % of body fat (β = −3.14, 95% CI: -5.18;-1.09; p = 0.003) compared to TT genotype. The AC genotype of ApaI SNP was associated with reduced waist circumference compared to AA genotype (β = −4.37, 95% CI: -7.54;-1.20; p = 0.007). GG genotype of EcoRV SNP was associated with reduced sum of skin fold thickness compared to AA genotype (β = −7.77, 95% CI: -14.34;-1.21; p = 0.020). In the multivariate modelling, multiple significant associations of VDR with investigated traits were observed, too.ConclusionOur study suggests that genetic variability in the VDR region may be an important factor influencing anthropometric characteristics associated with obesity.