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Real time continuous glucose monitoring in high-risk people with insulin-requiring type 2 diabetes: A randomised controlled trial.
Lever, Claire S; Williman, Jonathan A; Boucsein, Alisa; Watson, Antony; Sampson, Rachael S; Sergel-Stringer, Oscar T; Keesing, Celeste; Chepulis, Lynne; Wheeler, Benjamin J; de Bock, Martin I; Paul, Ryan G.
Afiliación
  • Lever CS; Te Huataki Waiora, School of Health, University of Waikato, Hamilton, New Zealand.
  • Williman JA; Waikato Regional Diabetes Service, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand.
  • Boucsein A; Biostatistics and Computation Biology Unit, University of Otago, Christchurch, New Zealand.
  • Watson A; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
  • Sampson RS; Department of Paediatrics, University of Otago, Christchurch, New Zealand.
  • Sergel-Stringer OT; Waikato Regional Diabetes Service, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand.
  • Keesing C; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
  • Chepulis L; Waikato Regional Diabetes Service, Te Whatu Ora Health New Zealand Waikato, Hamilton, New Zealand.
  • Wheeler BJ; Pinnacle Midlands Health Network, New Zealand.
  • de Bock MI; Te Huataki Waiora, School of Health, University of Waikato, Hamilton, New Zealand.
  • Paul RG; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Diabet Med ; 41(8): e15348, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38758653
ABSTRACT

AIMS:

To investigate the impact of real-time continuous glucose monitoring (rtCGM) on glycaemia in a predominantly indigenous (Maori) population of adults with insulin-requiring type 2 diabetes (T2D) in New Zealand.

METHODS:

Twelve-week, multicentre randomised controlled trial (RCT) of adults with T2D using ≥0.2 units/kg/day of insulin and elevated glycated haemoglobin (HbA1c) ≥64 mmol/mol (8.0%). Following a 2-week blinded CGM run-in phase, participants were randomised to rtCGM or control (self-monitoring blood glucose [SMBG]). The primary outcome was time in the target glucose range (3.9-10 mmol/L; TIR) during weeks 10-12, with data collected by blinded rtCGM in the control group.

RESULTS:

Sixty-seven participants entered the RCT phase (54% Maori, 57% female), median age 53 (range 16-70 years), HbA1c 85 (IQR 74, 94) mmol/mol (9.9 [IQR 8.9, 10.8]%), body mass index (36.7 ± 7.7 kg/m2). Mean (±SD) TIR increased from 37 (24)% to 53 (24)% [Δ 13%; 95% CI 4.2 to 22; P = 0.007] in the rtCGM group but did not change in the SMBG group [45 (21)% to 45 (25)%, Δ 2.5%, 95% CI -6.1 to 11, P = 0.84]. Baseline-adjusted between-group difference in TIR was 10.4% [95% CI -0.9 to 21.7; P = 0.070]. Mean HbA1c (±SD) decreased in both groups from 85 (18) mmol/mol (10.0 [1.7]%) to 64 (16) mmol/mol (8.0 [1.4]%) in the rtCGM arm and from 81 (12) mmol/mol (9.6 [1.1]%) to 65 (13) mmol/mol (8.1 [1.2]%) in the SMBG arm (P < 0.001 for both). There were no severe hypoglycaemic or ketoacidosis events in either group.

CONCLUSIONS:

Real-time CGM use in a supportive treat-to-target model of care likely improves glycaemia in a population with insulin-treated T2D and elevated HbA1c.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 2 / Monitoreo Continuo de Glucosa / Hipoglucemiantes / Insulina Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Diabet Med Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus Tipo 2 / Monitoreo Continuo de Glucosa / Hipoglucemiantes / Insulina Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Oceania Idioma: En Revista: Diabet Med Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Reino Unido