Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions, and Quality of Life: A Real-World Study

Charleer, Sara; Mathieu, Chantal; Nobels, Frank; Block, Christophe De; Radermecker, Régis; Hermans, Michel P.; Taes, Youri; Vercammen, Chris; T’Sjoen, Guy; Crenier, Laurent; Fieuws, Steffen; Keymeulen, Bart; Gillard, Pieter; Investigators, Rescue

doi:10.1210/jc.2017-02498

Cited by 146 publications

(139 citation statements)

References 26 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…In addition, hypoglycemia prevention is beneficial in young children with liver GSDs who are on overnight tube feeds; CGMS alarms can alert parents/caregivers to impending hypoglycemia and subsequently take corrective actions such as supplementary feeds or check for tube displacement or kinking. CGMS also leads to overall improvements in patients' perceptions about quality of life, as reported by patients #2 and #3 above and established in literature (Charleer et al 2018;Polonsky and Hessler 2013).…”

Section: Discussionsupporting

confidence: 62%

Role of continuous glucose monitoring in the management of glycogen storage disorders

Herbert

Pendyal

Rairikar

et al. 2018

J of Inher Metab Disea

View full text Add to dashboard Cite

Management of liver glycogen storage diseases (GSDs) primarily involves maintaining normoglycemia through dietary modifications and regular glucose monitoring. Self-monitoring of blood glucose is typically done 3-6 times per day, and may not sufficiently capture periods of asymptomatic hypoglycemia, particularly during sleep. Continuous glucose monitoring systems (CGMS) provide 24-h continuous glucose data and have been used effectively in diabetes mellitus to monitor metabolic control and optimize treatment. This is a relatively new approach in GSDs with only a handful of studies exploring this modality. In this study we used Dexcom CGMS to study the glycemic profile of 14 pediatric and six adult patients with GSD I, III, and IX. A total of 176 days of CGMS data were available. The CGMS was found to be a reliable tool in monitoring glucose levels and trends at all times of the day with good concordance with finger-stick glucose values. This study revealed that in addition to overnight hypoglycemia, CGMS can uncover previously undetected, subclinical, low glucose levels during daytime hours. Additionally, the CGMS detected daytime and overnight hyperglycemia, an often overlooked concern in liver GSDs. The CGMS with concurrent dietary adjustments made by a metabolic dietitian improved metabolic parameters and stabilized blood glucose levels. The CGMS was found to be a safe, effective, and reliable method for optimizing treatment in patients with GSD I, III, and IX.

show abstract

Section: Discussionsupporting

confidence: 62%

Role of continuous glucose monitoring in the management of glycogen storage disorders

Herbert

Pendyal

Rairikar

et al. 2018

J of Inher Metab Disea

View full text Add to dashboard Cite

show abstract

“…Taking into account a mean Belgian cost of V4,733 per hospitalization for hypoglycemia or ketoacidosis (3), the Belgian health care provider could save V151,456 of direct costs in the first year of isCGM reimbursement. However, the magnitude is much lower, which could be explained by low baseline incidence of diabetes-related admissions in the current cohort (3.3%) compared with the high incidence (16%) in the CGM trial, in which people were mainly selected on the basis of problematic hypoglycemia (3).…”

Section: Discussionmentioning

confidence: 72%

“…Since the introduction of continuous glucose monitoring (CGM), the daily burden of multiple daily finger-stick tests and the need to constantly carry a blood glucose meter, test strips, lancets, and blood glucose logbooks have been reduced. Moreover, favorable results on hypoglycemia risk, quality of life, and hospitalization rate have been reported (3)(4)(5)(6). However, widespread use of CGM has been hampered by high costs and lack of reimbursement (7), relatively short sensor lifetime, and need for daily calibration (8).…”

mentioning

confidence: 99%

Quality of Life and Glucose Control After 1 Year of Nationwide Reimbursement of Intermittently Scanned Continuous Glucose Monitoring in Adults Living With Type 1 Diabetes (FUTURE): A Prospective Observational Real-World Cohort Study

et al. 2019

Self Cite

View full text Add to dashboard Cite

In 2016, nationwide reimbursement of intermittently scanned continuous glucose monitoring (isCGM) for people living with type 1 diabetes treated in specialist diabetes centers was introduced in Belgium. We undertook a 12-month prospective observational multicenter real-world study to investigate impact of isCGM on quality of life and glycemic control. RESEARCH DESIGN AND METHODS Between July 2016 and July 2018, 1,913 adults with type 1 diabetes were consecutively recruited in three specialist diabetes centers. Demographic, metabolic, and quality of life data were collected at baseline, 6 months, and 12 months of standardized clinical follow-up. The primary end point was evolution of quality of life from baseline to 12 months. Secondary outcome measures were, among others, change in HbA 1c , time spent in different glycemic ranges, occurrence of acute diabetes complications, and work absenteeism. RESULTS General and diabetes-specific quality of life was high at baseline and remained stable, whereas treatment satisfaction improved (P < 0.0001). Admissions for severe hypoglycemia and/or ketoacidosis were rare in the year before study (n 5 63 out of 1,913; 3.3%), but decreased further to 2.2% (n 5 37 out of 1,711; P 5 0.031). During the study, fewer people reported severe hypoglycemic events (n 5 280 out of 1,913 [14.6%] vs. n 5 134 out of 1,711 [7.8%]; P < 0.0001) or hypoglycemic comas (n 5 52 out of 1,913 [2.7%] vs. n 5 18 out of 1,711 [1.1%]; P 5 0.001) while maintaining HbA 1c levels. Fewer people were absent from work (n 5 111 out of 1,913 [5.8%] vs. n 5 49 out of 1,711 [2.9%]; P < 0.0001). Time spent in hypoglycemia significantly decreased in parallel with less time in range and more time in hyperglycemia. Eleven percent (n 5 210) of participants experienced skin reactions, leading to stopping of isCGM in 22 participants (1%). CONCLUSIONS Nationwide unrestricted reimbursement of isCGM in people with type 1 diabetes treated in specialist diabetes centers results in higher treatment satisfaction, less severe hypoglycemia, and less work absenteeism, while maintaining quality of life and HbA 1c .

show abstract

“…31 Real-world use of CGM in a prospective observational trial of type 1 diabetes showed an almost 75% reduction in hospitalization for hypoglycemia and a reduction of 68% in days of hospitalization per 100 patient-years. 32 Results in type 2 diabetes are less dramatic, due to the decreased frequency of hypoglycemia.…”

Section: S2-50mentioning

confidence: 99%

Hypoglycemia: New Definitions and Regulatory Implications

Ratner¹

2018

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

Hypoglycemia is the limiting factor in controlling glucose levels in Diabetes. Rather than being a side effect, hypoglycemia is the mechanism of action for insulin therapy, with a very narrow therapeutic window. Until recently, regulatory bodies listed hypoglycemia only as an adverse effect of therapy; however, one insulin preparation is now recognized and labelled as reducing the risk of severe hypoglycemia. This paper describes internationally agreed upon definitions for hypoglycemia and proposed regulatory approaches for recognition and labeling of diabetes therapies to facilitate personalized care.

show abstract

Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions, and Quality of Life: A Real-World Study

Abstract: Sensor-augmented pump therapy in patients with T1D followed in specialized centers improves HbA1c, fear of hypoglycemia, and QOL, whereas work absenteeism and admissions for acute diabetes complications decreased.

Cited by 146 publications

References 26 publications

Role of continuous glucose monitoring in the management of glycogen storage disorders

Role of continuous glucose monitoring in the management of glycogen storage disorders

Quality of Life and Glucose Control After 1 Year of Nationwide Reimbursement of Intermittently Scanned Continuous Glucose Monitoring in Adults Living With Type 1 Diabetes (FUTURE): A Prospective Observational Real-World Cohort Study

Hypoglycemia: New Definitions and Regulatory Implications

Contact Info

Product

Resources

About