Use of intermittently scanned continuous glucose monitoring in young people with high‐risk type 1 diabetes – extension phase outcomes following a 6‐month randomised control trial

2021 ◽  
Author(s):  
Shelley Rose ◽  
Sara E. Styles ◽  
Esko J. Wiltshire ◽  
James Stanley ◽  
Barbara C. Galland ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Young People ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Extension Phase ◽  
Randomised Control Trial ◽  
High Risk Type

scholarly journals Use of continuous glucose monitoring trend arrows in the younger population with type 1 diabetes

2021 ◽  
Vol 18 (6) ◽  
pp. 147916412110621
Author(s):  
Nancy Elbarbary ◽  
Othmar Moser ◽  
Saif Al yaarubi ◽  
Hussain Alsaffar ◽  
Adnan Al Shaikh ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young People ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Vascular Complications ◽  
Rate Of Change ◽  
Rapid Expansion ◽  
Nocturnal Hypoglycaemia ◽  
Glucose Levels

Early control of glycaemia is key to reduce vascular complications in individuals with Type 1 diabetes. Therefore, encouraging children and adolescents with T1DM to take responsibility for controlling glucose levels is an important yet a challenging task. The rapid expansion of continuous glucose monitoring (CGM) systems has allowed for more comprehensive analysis of glycaemia in T1D. Moreover, CGM devices have the ability to calculate rate of change in glucose levels and display the information as trend arrows. In turn, this can help to take evasive actions to return glucose levels to near physiological glycaemia, which can be highly motivating for young people with T1DM. In the absence of standardised, evidence-based guidance, this consensus document, generated by experts from the Arab Society of Paediatric Endocrinology and Diabetes and international advisors, summarises recent literature on the use of trend arrows in young people with T1DM. The use of trend arrows in different CGM systems is reviewed and their clinical significance is highlighted. Adjusting insulin doses according to trend arrows is discussed while also addressing special situations, such as exercise, fasting, nocturnal hypoglycaemia and menstruation. Adequate understanding of trend arrows should facilitate optimisation of glycaemic control in the T1D population.

scholarly journals Glycemic Variability and Hypoglycemic Excursions With Continuous Glucose Monitoring Compared to Intermittently Scanned Continuous Glucose Monitoring in Adults With Highest Risk Type 1 Diabetes

2019 ◽  
Vol 14 (3) ◽  
pp. 567-574 ◽  
Author(s):  
Parizad Avari ◽  
Vanessa Moscardo ◽  
Narvada Jugnee ◽  
Nick Oliver ◽  
Monika Reddy
Keyword(s):  
Type 1 Diabetes ◽  
High Risk ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Severe Hypoglycemia ◽  
Glycemic Variability ◽  
Clinical Trial Registration ◽  
Freestyle Libre ◽  
The Impact

Background: The I-HART CGM study has shown that real-time continuous glucose monitoring (rtCGM) has greater beneficial impact on hypoglycemia than intermittently scanned continuous glucose monitoring (iscCGM) in adults with type 1 diabetes at high risk (Gold score ≥4 or recent severe hypoglycemia using insulin injections). In this subanalysis, we present the impact of rtCGM and iscCGM on glycemic variability (GV). Methods: Forty participants were recruited to this parallel group study. Following two weeks of blinded rtCGM (DexcomG4), participants were randomized to rtCGM (Dexcom G5; n = 20) or iscCGM (Freestyle Libre; n = 20) for eight weeks. An open-extension phase enabled participants on rtCGM to continue for a further eight weeks and those on iscCGM to switch to rtCGM over this period. Glycemic variability measures at baseline, 8- and 16-week endpoints were compared between groups. Results: At the eight-week endpoint, between-group differences demonstrated significant reduction in several GV measures with rtCGM compared to iscCGM (GRADE%hypoglycemia, index of glycemic control [IGC], and average daily risk range [ADRR]; P < .05). Intermittently scanned continuous glucose monitoring reduced mean average glucose and glycemic variability percentage and GRADE%hyperglycemia compared with rtCGM ( P < .05). At 16 weeks, the iscCGM group switching to rtCGM showed significant improvement in GRADE%hypoglycemia, personal glycemic status, IGC, and ADRR. Conclusion: Our data suggest most, but not all, GV measures improve with rtCGM compared with iscCGM, particularly those measures associated with the risk of hypoglycemia. Selecting appropriate glucose monitoring technology to address GV in this high-risk cohort is important to minimize the risk of glucose extremes and severe hypoglycemia. Clinical trial registration: ClinicalTrials.gov NCT03028220

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