Predictors of the effectiveness of isCGM usage in adults with type 1 diabetes mellitus: post-hoc analysis of the ISCHIA study

ISCHIA Study Group; Takashi Murata; Yushi Hirota; Kiminori Hosoda; Ken Kato; Kunichi Kouyama; Ryuji Kouyama; Akio Kuroda; Yuka Matoba; Munehide Matsuhisa; Shu Meguro; Junnosuke Miura; Kunihiro Nishimura; Naoki Sakane; Akira Shimada; Shota Suzuki; Atsuhito Tone; Masao Toyoda

doi:10.1007/s13340-023-00683-5

Predictors of the effectiveness of isCGM usage in adults with type 1 diabetes mellitus: post-hoc analysis of the ISCHIA study

Diabetol Int. 2024 Feb 15;15(3):400-405. doi: 10.1007/s13340-023-00683-5. eCollection 2024 Jul.

Authors

ISCHIA Study Group; Takashi Murata^{1

2}, Yushi Hirota³, Kiminori Hosoda⁴, Ken Kato⁵, Kunichi Kouyama⁶, Ryuji Kouyama⁷, Akio Kuroda⁸, Yuka Matoba⁹, Munehide Matsuhisa⁸, Shu Meguro¹⁰, Junnosuke Miura¹¹, Kunihiro Nishimura¹², Naoki Sakane¹³, Akira Shimada¹⁴, Shota Suzuki¹⁵, Atsuhito Tone¹⁶, Masao Toyoda¹⁷

Collaborators

ISCHIA Study Group:
Kiminori Hosoda, Kunihiro Nishimura, Yoshihiro Miyamoto, Takashi Murata, Naoki Sakane, Noriko Satoh-Asahara, Masao Toyoda, Yushi Hirota, Munehide Matsuhisa, Akio Kuroda, Ken Kato, Ryuji Kouyama, Junnosuke Miura, Atsuhito Tone, Masato Kasahara, Shu Kasama, Shota Suzuki, Yukie Ito, Tomokazu Watanabe, Akiko Suganuma, Zhuo Shen, Hiroko Kobayashi, Satoshi Takagi, Sari Hoshina, Kanako Shimura, Yukiko Tsuchida, Moritsugu Kimura, Nobumichi Saito, Akira Shimada, Yoichi Oikawa, Atsushi Satomura, Akifumi Haisa, Satoshi Kawashima, Shu Meguro, Hiroshi Itoh, Yoshifumi Saisho, Junichiro Irie, Masami Tanaka, Masanori Mitsuishi, Yuya Nakajima, Jun Inaishi, Kenichiro Kinouchi, Shintaro Yamaguchi, Arata Itoh, Kazutoshi Sugiyama, Kazuma Yagi, Tami Tsuchiya, Noriko Kodani, Ikki Shimizu, Tetsuya Fukuda, Yoshiki Kusunoki, Tomoyuki Katsuno, Yuka Matoba, Yumi Hitaka, Kentaro Abe, Natsuko Tanaka, Ryoko Taniguchi, Toshihiko Nagao, Kazuyuki Hida, Izumi Iseda, Masaya Takeda, Yuichi Matsushita, Masafumi Tenta, Tsuyoshi Tanaka, Kunichi Kouyama, Michiru Fukunaga

Affiliations

¹ Department of Clinical Nutrition, NHO Kyoto Medical Center, 1-1 Fukakusamukaihata-cho, Fushimi-ku, Kyoto, 612-8555 Japan.
² Diabetes Center, NHO Kyoto Medical Center, Kyoto, Japan.
³ Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan.
⁴ Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, Osaka, Japan.
⁵ Diabetes Center, NHO Osaka National Hospital, Osaka, Japan.
⁶ Department of Diabetes and Metabolism, NHO Hyogo-Chuo National Hospital, Hyogo, Japan.
⁷ Division of Endocrinology and Metabolism, Department of Internal Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
⁸ Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
⁹ Department of Diabetes, Endocrinology and Metabolism, NHO Kokura Medical Center, Fukuoka, Japan.
¹⁰ Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
¹¹ Diabetes Center, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.
¹² Department of Preventive Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
¹³ Division of Preventive Medicine, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan.
¹⁴ Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
¹⁵ Institute for Clinical and Translational Science, Nara Medical University Hospital, Nara, Japan.
¹⁶ Department of Internal Medicine, Okayama Saiseikai General Hospital, Okayama, Japan.
¹⁷ Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Kanagawa, Japan.

PMID: 39101179
PMCID: PMC11291818 (available on 2025-02-15)
DOI: 10.1007/s13340-023-00683-5

Abstract

Aim: The Effect of Intermittent-Scanning Continuous Glucose Monitoring to Glycemic Control Including Hypoglycemia and Quality of Life of Patients with Type 1 Diabetes Mellitus (ISCHIA) study was a randomized, crossover trial that reported the decrease in time below range (TBR) by the use of intermittent-scanning continuous glucose monitoring (isCGM) combined with structured education in adults with type 1 diabetes (T1D) treated by multiple daily injections. The participants were instructed to perform frequent scanning of the isCGM sensor (10 times a day or more) and ingest sugar when impending hypoglycemia is suspected by tracking the sensor glucose levels and the trend arrow. We conducted post-hoc analysis to identify factors affecting difference in TBR (∆TBR), in time in range (∆TIR), and in time above range (∆TAR).

Participants and methods: Data from 93 participants who completed the ISCHIA study were used. Multiple regression analyses were performed to identify factors affecting CGM metrics.

Results: Pearson's correlation analysis showed the negative association between log-transformed scan frequency and with ∆TBR (r = - 0.255, P = 0.015), while there was no significant association of log-transformed scan frequency with ∆TIR (r = 0.172, P = 0.102) and ∆TAR (r = 0.032, P = 0.761), respectively. The log-transformed scan frequency was an independent predictor of ∆TBR (Beta = - 7.712, P = 0.022), but not of ∆TIR(Beta = 7.203, P = 0.091) and of ∆TAR (Beta = 0.514, P = 0.925).

Conclusions: Our findings suggest that more frequent scanning of isCGM may be beneficial to reduce TBR in T1D adults.

Keywords: Hypoglycemia; Sensor scanning; Type 1 diabetes; isCGM.

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