medwireNews: The benefits of switching from intermittently scanned to real-time continuous glucose monitoring (isCGM to rtCGM) in adults with type 1 diabetes are sustained for at least 2 years, shows the extension of the ALERTT1 study.
The primary findings showed a significant improvement in time in range at 6 months, from 52.5% to 59.6%. During the extension, this increased by a further 3.4 percentage points to reach 63.0% by month 12 and remained stable through month 24 in the 117 participants who completed the trial.
And 112 participants completed the extension having switched to rtCGM at month 6. Their time in range improved from 51.8% to 63.5% at month 12 and remained stable through month 24.
Participants’ scores on the Hypoglycaemia Fear Survey version II worry subscale improved over the 24-month period by a significant average of 5.17 and 2.67 points in those who started rtCGM at baseline and those who switched to it at month 6, respectively.
Time in hypoglycemia did not further improve after the first 6 months of rtCGM use in either group, although it remained stable, report Pieter Gillard (University Hospitals Leuven – KU Leuven, Belgium) and co-researchers in The Lancet Diabetes & Endocrinology.
In a linked commentary, Kirsten Nørgaard and Ulrik Pedersen-Bjergaard, both from the University of Copenhagen in Denmark, note that the cohort was relatively well educated and with reasonable glycemic control at baseline.
“Therefore, we expect in real-world settings that changing from isCGM to rtCGM might result in even more pronounced improvements in glycaemic outcomes,” they say.
They advocate for more research on how to improve blood glucose levels using rtCGM “without the potential side-effects associated with frequent alarms (ie, alarm fatigue, diabetes distress, and sleep deprivation).”
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Lancet Diabetes Endocrinol 2023; doi:10.1016/S2213-8587(22)00352-7
Lancet Diabetes Endocrinol 2023; doi:10 1016/S2213-8587(22)00385-0