Real-time glucose monitoring offers long-term benefits
MedWire News: Real-time continuous glucose monitoring (RT-CGM) has long-term glycemic-lowering effects in patients with Type 2 diabetes who are not on prandial insulin, report researchers.
The benefits of intermittent use of RT-CGM over 12 weeks last for up to 1 year after the intervention, report Robert Visersky (Walter Reed National Military Medical Center, Maryland, USA) and colleagues.
"RT-CGM has not been used as a tool for diabetes management in patients with Type 2 diabetes who are not taking prandial insulin, by far the largest subgroup of people with Type 2 diabetes," they say. "Their glycemic monitoring relies on self-monitoring of blood glucose (SMBG) at a frequency and time of day commensurate with their treatment regimen."
In a previous study, the researchers demonstrated that, among Type 2 diabetes patients not on prandial insulin, adding RT-CGM to SMBG over 12 weeks significantly reduced HbA1c by 1.0%, compared with only 0.5% in patients using SMBG alone.
In the study, RT-CGM was used in four 3-week cycles (2 weeks on/1 week off) and patients in both groups were asked to perform SBMG before meals, at bedtime, and if they experienced symptoms of hypo- or hyperglycemia.
In the current study, the researchers followed-up the cohort for a further 40 weeks after RC-TGM was stopped. Both groups continued with SMBG for the duration of the study.
As reported in the journal Diabetes Care, HbA1c decreased by 1.0%, 1.2%, 0.8%, and 0.8% in the RT-CGM group versus 0.5%, 0.5%, 0.5%, and 0.2% in the SMBG group at 12, 24, 38, and 52 weeks, respectively.
After adjustment for covariates, there was a significantly greater decline in HbA1c from baseline in the RT-CGM group compared with the SMBG group (0.9 vs 0.4%, 1.0 vs 0.5%, 1.1 vs 0.5%, and 1.1% vs 0.5% at 12, 24, 38, and 52 weeks, respectively).
Individuals who wore the RT-CGM sensor for 48 days or more had a greater drop in HbA1c than those who wore it for less than 48 days (1.2 vs 0.6%, 1.5 vs 0.6%, 1.1 vs 0.2%, and 1.0 vs 0.3% at 12, 24, 38, and 52 weeks, respectively).
"These findings raise the possibility that periodic use of the technology every few months might be beneficial," say the researchers.
"Additional studies will be needed to confirm these results as well as determine the mechanism by which the improvement occurred, the minimum time for RT-CGM to be effective, and the effect/timing of refresher courses of this intervention," they conclude.
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By Sally Robertson