Real-time continuous glucose monitoring improves glycemic control and reduces hypoglycemia: Real-world data |
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| Affiliation: | 1. Division of Endocrinology, Diabetes and Nutrition, Medical University of South Carolina, AnMed Campus, Anderson, SC 29621, United States;2. Department of Medicine, Medical University of South Carolina, AnMed Campus, Anderson, SC 29621, United States;3. Department of Medicine, Bon Secours Saint Francis Health System, Greenville, SC 29601, United States;4. Department of Surgery, MercyOne Des Moines, Des Moines, Iowa, IA 50314, Unites States;5. Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD 21201, United States;6. Biostatistician, School of Nursing, Clemson University, Clemson, SC 29634, United States;1. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran;2. Students Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran;3. Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran;4. School of Medicine, Sabzevar University Of Medical Sciences, Sabzevar, Iran;1. Steno Diabetes Center Copenhagen, Herlev, Denmark;2. Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark;3. Department of Clinical Biochemistry, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark;4. Department of Hematology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;5. Department of Public Health, University of Copenhagen, Copenhagen, Denmark;1. Health Centre Zagreb-West, Croatia;2. Private Primary Practice Office, Zagreb, Croatia;1. Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China;2. Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA;1. Department of Community Health and Family Medicine, Bangalore Baptist Hospital, Bengaluru, India;2. Department of Clinical Research, ICMR- National Institute for Research in Tuberculosis, Chennai, India;3. Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, USA;4. Department of Psychiatry, St John''s Medical College Hospital, Bengaluru, Karnataka, India;5. Division of Mental Health and Neurosciences, St. John''s Research Institute, St. John''s National Academy of Health Sciences, Bengaluru, Karnataka, India;1. First Department of Propaedeutic Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece;2. Department of Health Policy, London School of Economics and Political Science, London, UK;3. Cardiology Department, Laiko General Hospital, Athens, Greece, London School of Economics and Political Science, London, UK;4. Cardiology Department, Laiko General Hospital, Athens, Greece;5. Second Department of Internal Medicine, Propaedeutic and Research Institute, Athens University Medical School, “Attikon” University Hospital, Athens, Greece |
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| Abstract: | AimTo study the effect of real time continuous glucose monitor (RT-CGM) use on glycemic parameters in patients with diabetes mellitus (DM) in real world practice.MethodsWe retrospectively studied 91 adult subjects with DM who had been using Dexcom? RT-CGM. Two consecutive hemoglobin A1c (HbA1c), both prior to and after at least 3 months of RT-CGM initiation, were collected. A total of 31 subjects completed a 5–14 day user blinded CGM using a Freestyle Libre? prior to RT-CGM initiation. The first two week period following at least 3 months use of RT-CGM was analyzed for CGM metrics.ResultsA total of 51.6 % of subjects had T1DM, 34.1 % used continuous subcutaneous insulin infusion (CSII), and 62.6 % had DM for > 10 years. Both HbA1c obtained following RT-CGM initiation decreased significantly compared to baseline (8.11 + 1.47% vs 7.69 + 1.25 %; P = 0.002 & 8.16 + 1.51 % vs 7.62 + 1.06 %; P = 0.001). Subjects with baseline HbA1c > 7.0 % showed even more robust reduction in both HbA1c after RT-CGM initiation (8.74 + 1.24 % vs 7.99 + 1.22 %; P = 0.000 & 8.74 + 1.32 % vs 7.85 + 1.07 %; P = 0.001). On comparison of CGM metrics, there was a significant reduction in time spent in hypoglycemia (sugars < 70 mg/dl) including severe hypoglycemia (sugars < 54 mg/dl) after initiation of the RT-CGM (9.16 + 8.68 % vs 1.29 + 2.21 %; P = <0.001 & 4.58 + 5.43 % vs 0.28 + 0.58 %; P = <0.001). CoV of glucose was also decreased significantly (39.61 + 9.36 % vs 31.06 + 6.74 %; P = <0.001) with RT- CGM use.ConclusionRT-CGM use for at least 3 months in patients with DM results in meaningful HbA1c reductions with stable glycemic control without increasing the risk of hypoglycemia. |
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| Keywords: | Continuous Glucose Monitoring CGM Dexcom Diabetes Hypoglycemia HbA1c Glucose coefficient of variation |
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