Transitory beneficial effects of professional continuous glucose monitoring on the metabolic control of patients with type 1 diabetes

Diabetes Technol Ther. 2014 Apr;16(4):219-23. doi: 10.1089/dia.2013.0266.

Abstract

Background: The benefit of professional continuous glucose monitoring (PCGM) in the metabolic control of patients with type 1 diabetes mellitus (T1DM) is uncertain.

Subjects and methods: This was a retrospective study of all consecutive T1DM patients who underwent a 6-day PCGM in our Diabetes Unit over the course of 17 months. According to the indication, two groups were arbitrarily defined: "hyperglycemic" and "hypoglycemic." Data from medical files and sensor reports were reviewed. Glycated hemoglobin (HbA1c) was evaluated 2-4 weeks prior to PCGM, as well as 3-5 and 12 months after PCGM. In the hypoglycemic group, the number of self-reported mild hypoglycemic episodes (as defined by the American Diabetes Association) was collected.

Results: Of the 67 patients reviewed, 43 were in the hyperglycemic group, and 24 were in the hypoglycemic group. In the hyperglycemic group, the HbA1c level dropped at 3-5 months post-intervention from 8.45 ± 0.72% to 8.04 ± 0.9%, with the decline being statistically significant (-0.4%; P = 0.001) and positively correlated with the initial HbA1c value (0.366; P=0.016). One year after the PCGM study, the HbA1c level tended to return to the initial values: 8.20 ± 1.05% (-0.24%; P = 0.081). In the hypoglycemic group, HbA1c did not change either 3-5 or 12 months after PCGM, although the percentage of patients in whom the number of mild hypoglycemic episodes was significantly reduced was 86% (P=0.001).

Conclusions: Although a transient phenomenon, PCGM can be useful in the short term in improving metabolic and clinical profile of suboptimally controlled T1DM subjects, including those with repeated hypoglycemia.

MeSH terms

  • Adult
  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin / metabolism*
  • Humans
  • Hyperglycemia / blood*
  • Hyperglycemia / drug therapy
  • Hypoglycemia / blood*
  • Hypoglycemia / prevention & control
  • Male
  • Monitoring, Physiologic*
  • Quality of Life
  • Retrospective Studies
  • Time Factors

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human