medwireNews: Further findings from the pilot I-HART randomized trial suggest that switching from flash to continuous glucose monitoring (CGM) reduces the time patients with type 1 diabetes spend in hypoglycemia.
Presenting the findings at the Advanced Technologies & Treatments for Diabetes conference in Vienna, Austria, Monika Reddy (Imperial College London, UK) suggested that the observed improvement is likely due to the alarms available with real-time CGM, helping patients to deal promptly with hypoglycemia.
She also noted that they used different devices for the flash and CGM groups, which could have influenced the findings.
I-HART was a small randomized trial of flash monitoring versus CGM, involving 40 patients with type 1 diabetes and impaired hypoglycemia awareness (Gold score ≥4) who used their allocated device for 8 weeks. As previously reported, patients using CGM had significantly greater reductions in hypoglycemia than those using flash monitoring, although there was only weak evidence for an improvement in hypoglycemia awareness.
Reddy reported the results of the 8-week extension phase, in which all 20 patients initially randomized to flash monitoring switched to CGM, and the 16 CGM users who remained in the trial continued to use the same devices.
Switching from flash to CGM resulted in a significant reduction in the amount of time spent in hypoglycemia, from 6.8% at 8 weeks to 1.5% at 16 weeks for hypoglycemia defined as blood glucose below 60 mg/dL (3.3 mmol/L). There were also significant falls in the time spent below 50 mg/dL (2.8 mmol/L), from 3.8% to 0.5%, and below 70 mg/dL (3.9 mmol/L), from 11.0% to 3.9%.
Time in hyperglycemia did not change in patients who moved from flash to CGM and hypoglycemia awareness did not significantly improve, as in the randomized phase of the trial. Patients who remained on CGM throughout maintained the benefits they gained during the first 8 weeks of use.
“It’s very important from a clinical point of view, I think, that we choose our technology appropriately to gain the most benefit for our patients,” concluded Reddy.
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