Effects of real-time continuous glucose monitoring in type 1 diabetes: a meta-analysis of randomized controlled trials

Dicembrini, Ilaria; Cosentino, Claudia; Monami, Matteo; Mannucci, Edoardo; Pala, Laura

doi:10.1007/s00592-020-01589-3

Cited by 60 publications

(118 citation statements)

References 52 publications

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…Data are expressed as mean ± standard deviation or median [Q1;Q3] from 21 T1D patients switching from FSL (M0) to DG4 followed-up at 3 months (M3), at 6 months (M6) and at 12 months (M12, end-point). 1 Data represent average values calculated from the data collected on the ambulatory glucose profile report over 3 months (for M0 during the last 3 months of FSL1 use, for M3 during the first 3 months of DG4 use, and during the last 3 months of DG4 use for M6 and M12). 2 Data are expressed as percent of time over a 3 month-period.…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…Continuous Glucose Monitoring (CGM) is the standard practice for improving the overall glycemic control providing different glucose metrics (Time-In-Range 70-180 mg/dL (TIR), Time-Below-Range <70 mg/dL (TBR) and TBR<54 mg/dL, Coefficient of Variation (%CV) of glucose, Glucose Management Indicator (GMI), average interstitial glucose (IG) concentration), ameliorating sometimes HbA1c, the quality of life of type 1 diabetes (T1D) patients, and even hypoglycemia awareness in patients with hypoglycemic issue [1][2][3]. The choice of the best suited CGM sensor for each patient is a major therapeutic decision, which can positively influence the risk of complications, acute or even chronic [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Benefits of a Switch From Intermittently Scanned Continuous Glucose Monitoring (isCGM) to Real-time (rt) CGM in Diabetes Type 1 Suboptimal Controlled Patients in Real-life: A One-year Prospective Study

Préau¹,

Galie²,

Schaepelynck³

et al. 2021

Preprint

View full text Add to dashboard Cite

The switch from intermittently scanned continuous glucose monitoring (isCGM) to real-time (rt) CGM could improve glycemic management in suboptimal controlled type 1 diabetes patients, but long-term study is lacking. We evaluated retrospectively the ambulatory glucose profile (AGP) in such patients after switching from Free Style libre 1 (FSL1) to Dexcom G4 (DG4) over 1 year. Patients (n=21, 43±15 years, BMI 25±5, HbA1c 8.1±1.0%) had severe hypoglycemia and/or HbA1c≥8%. AGP metrics (time-in-range (TIR) 70-180 mg/dL, time-below-range (TBR)<70 mg/dL or <54 mg/dL, glucose coefficient of variation (%CV), time-above-range (TAR) >180 mg/dL or >250 mg/dL, glucose management indicator (GMI), average glucose) were collected the last 3 months of FSL1 use (M0) and of DG4 for 3, 6 (M6) and 12 (M12) months of use. Values were means ± standard deviation or medians [Q1;Q3]. At M12 versus M0, the higher TIR (50±17 vs. 45±16, P=0.036), and lower TBR<70 mg/dL (2.5 [1.6;5.5] vs. 7.0 [4.5;12.5], P=0.0007), TBR<54 mg/dL (0.7 [0.4;0.8] vs. 2.3 [0.8;7.0], P=0.007) and %CV (39±5 vs. 45±8, P=0.0009), evidenced a long-term effectiveness of the switch. Compared to M6, TBR<70mg/dL decreased, %CV remained stable, while the improvement on hyperglycemia exposure decreased (higher GMI, TAR and average glucose). This switch was a relevant therapeutic option, though a loss of benefit on hyperglycemia stressed the need for optimized management of threshold alarms. Nevertheless, few patients attained the recommended values for AGP metrics, and the reasons why some patients are “responders” vs “non-responders” warrant to be investigated.

show abstract

Section: Patient Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Benefits of a Switch From Intermittently Scanned Continuous Glucose Monitoring (isCGM) to Real-time (rt) CGM in Diabetes Type 1 Suboptimal Controlled Patients in Real-life: A One-year Prospective Study

Préau¹,

Galie²,

Schaepelynck³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Of these 70 potentially relevant articles, 54 publications were excluded for various reasons, and 16 publications met the inclusion criteria and were included in this report. These comprised 3 health technology assessments [14][15][16] (that each included a systematic review with 14,15 or without 16 meta-analysis), 5 systematic reviews [17][18][19][20][21] (3 with meta-analysis 17,19,21 ), 2 publications 22,23 related to 1 randomized controlled trial (RCT), and 6 non-randomized studies. [24][25][26][27][28][29] Appendix 1 presents the PRISMA 30 flow chart of the study selection.…”

Section: Quantity Of Research Availablementioning

confidence: 99%

Flash Glucose Monitoring Systems in Pediatric Populations With Diabetes

Young¹,

Grobelna²

2021

cjht

View full text Add to dashboard Cite

Flash glucose monitoring (FGM) is a method of glucose testing where a sensor inserted into the skin continuously measures interstitial glucose levels. It can be used by people with diabetes to inform treatment decisions, such as insulin dosing, as an alternative or complement to blood glucose testing. Evidence of variable quality from 2 randomized controlled trials and 8 non-randomized studies, including those summarized within systematic reviews, suggests that FGM may improve quality of life, patient satisfaction, diabetes distress, self-efficacy, and frequency of glucose monitoring compared to self-monitoring blood glucose techniques in pediatric populations with type 1 diabetes. Findings related to other outcomes, such as hemoglobin A1C, glucose time in range metrics, and adverse events were mixed or inconclusive (i.e., in some studies the use of FGM was associated with improved outcomes, while in other studies it was not). While the results summarized in this report generally suggest that the use of FGM is associated with improved clinical outcomes in pediatric populations with type 1 diabetes, the limitations of the included literature should be considered when interpreting these findings. No studies were identified that compared the clinical effectiveness of FGM systems with hypoglycemic, hyperglycemia, or signal loss alarms (e.g., FreeStyle Libre 2) to FGM systems without these features (e.g., FreeStyle Libre) in people of any age with diabetes requiring insulin therapy.

show abstract

“…Continuous glucose monitoring (CGM) is the standard practice for improving the overall glycemic control providing different glucose metrics (time-in-range 70–180 mg/dL (TIR), time-below-range <70 mg/dL (TBR) and TBR < 54 mg/dL, coefficient of variation (%CV) of glucose, glucose management indicator (GMI), average interstitial glucose (IG) concentration), ameliorating sometimes HbA1c, the quality of life of type 1 diabetes (T1D) patients, and even hypoglycemia awareness in patients with hypoglycemic issue [ 1 , 2 , 3 ]. The choice of the best suited CGM devices for each patient is a major therapeutic decision, which can positively influence the risk of complications, acute or even chronic [ 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Benefits of a Switch from Intermittently Scanned Continuous Glucose Monitoring (isCGM) to Real-Time (rt) CGM in Diabetes Type 1 Suboptimal Controlled Patients in Real-Life: A One-Year Prospective Study §

Préau

Galie

Schaepelynck

et al. 2021

Sensors

View full text Add to dashboard Cite

The switch from intermittently scanned continuous glucose monitoring (isCGM) to real-time (rt) CGM could improve glycemic management in suboptimal controlled type 1 diabetes patients, but long-term study is lacking. We evaluated retrospectively the ambulatory glucose profile (AGP) in such patients after switching from Free Style Libre 1 (FSL1) to Dexcom G4 (DG4) biosensors over 1 year. Patients (n = 21, 43 ± 15 years, BMI 25 ± 5, HbA1c 8.1 ± 1.0%) had severe hypoglycemia and/or HbA1c ≥ 8%. AGP metrics (time-in-range (TIR) 70–180 mg/dL, time-below-range (TBR) <70 mg/dL or <54 mg/dL, glucose coefficient of variation (%CV), time-above-range (TAR) >180 mg/dL or >250 mg/dL, glucose management indicator (GMI), average glucose) were collected the last 3 months of FSL1 use (M0) and of DG4 for 3, 6 (M6) and 12 (M12) months of use. Values were means ± standard deviation or medians [Q1;Q3]. At M12 versus M0, the higher TIR (50 ± 17 vs. 45 ± 16, p = 0.036), and lower TBR < 70 mg/dL (2.5 [1.6;5.5] vs. 7.0 [4.5;12.5], p = 0.0007), TBR < 54 mg/dL (0.7 [0.4;0.8] vs. 2.3 [0.8;7.0], p = 0.007) and %CV (39 ± 5 vs. 45 ± 8, p = 0.0009), evidenced a long-term effectiveness of the switch. Compared to M6, TBR < 70 mg/dL decreased, %CV remained stable, while the improvement on hyperglycemia exposure decreased (higher GMI, TAR and average glucose). This switch was a relevant therapeutic option, though a loss of benefit on hyperglycemia stressed the need for optimized management of threshold alarms. Nevertheless, few patients attained the recommended values for AGP metrics, and the reasons why some patients are “responders” vs. “non-responders” warrant to be investigated.

show abstract

Effects of real-time continuous glucose monitoring in type 1 diabetes: a meta-analysis of randomized controlled trials

Cited by 60 publications

References 52 publications

Benefits of a Switch From Intermittently Scanned Continuous Glucose Monitoring (isCGM) to Real-time (rt) CGM in Diabetes Type 1 Suboptimal Controlled Patients in Real-life: A One-year Prospective Study

Benefits of a Switch From Intermittently Scanned Continuous Glucose Monitoring (isCGM) to Real-time (rt) CGM in Diabetes Type 1 Suboptimal Controlled Patients in Real-life: A One-year Prospective Study

Flash Glucose Monitoring Systems in Pediatric Populations With Diabetes

Benefits of a Switch from Intermittently Scanned Continuous Glucose Monitoring (isCGM) to Real-Time (rt) CGM in Diabetes Type 1 Suboptimal Controlled Patients in Real-Life: A One-Year Prospective Study §

Contact Info

Product

Resources

About