medwireNews: The improved glycemic control gained from use of intermittently scanned continuous glucose monitoring (isCGM) is sustained for at least 2 years in people with type 1 diabetes, show real-world data.
However, researcher Morten Hasselstrøm Jensen (Steno Diabetes Center North Denmark, Aalborg) stressed his belief that education is “pivotal” to achieve these long-term benefits.
All people who started on an isCGM in North Denmark during the study period of 2020–2021 received a 2-hour group training session plus half-hour individual session at baseline and 3 months later.
The presenter told delegates at the 58th EASD Annual Meeting in Stockholm, Sweden, that most studies of isCGM have lasted only about 3–6 months, and researchers suspect that the majority of benefit from digital interventions may be soon after initiation, with the durability of benefit remaining unclear.
In this study, the baseline average glycated hemoglobin (HbA1c) level was higher in the 897 people who subsequently started using isCGM than in the 1630 who did not, at 79.5 versus 64.1 mmol/mol (9.4 vs 8.0%). These isCGM starters were also younger than the non-users, but had a similar duration of diabetes and prevalence of chronic complications.
HbA1c levels were stable in both groups for the 12 months prior to isCGM initiation, after which they remained stable in the non-users but fell rapidly across the first 3 months in the device initiators. After this, HbA1c stayed relatively consistent again for up to 24 months of follow-up, with an average 5.68 mmol/mol (0.52%) difference between the two groups favoring isCGM use after accounting for age, sex, diabetes duration, and insulin pump use.
The greatest beneficiaries in terms of improved glucose control appeared to be people with HbA1c higher than 86 mmol/mol (10%) at baseline and those younger than 68 years.
However, Hasselstrøm Jensen observed that “in principle,” the isCGM users and non-users “cannot be compared at all,” given the intensive education provided to one group but not the other. But he said the comparison used is “the best that we have” in terms of a real-world study.
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