Improved Glycemic Control in Poorly Controlled Patients with Type 1 Diabetes Using Real-Time Continuous Glucose Monitoring

Real-time continuous glucose monitoring (CGM) integrated into the treatment of type 1 diabetes: Consensus of experts from SFD, EVADIAC and SFE

“…A recent meta-analysis confirms these results [27] and a Cochrane review appeared a short while ago [28]. The improvement is observed at 3 months [23] and maintained at 6 months [24], 12 months [26,29,30] and 18 months [24], the maximum follow-up of the studies to date. The improvement is observed whatever the initial level of HbA 1c is, whether the patient uses a pump or multiple daily injections [21] and however long a pump has previously been used by a particular patient.…”

“…The results of these studies are detailed in Table 2. Use of CGM for less than 40% of the prescribed time denies the patient this improvement [23]. A recent meta-analysis confirms these results [27] and a Cochrane review appeared a short while ago [28].…”

“…The information provided by CGM is constantly accessible and permits the patient to adjust daily insulin dosing, avoid unnoticed high or low glucose levels and thus improve his glucose control. In the studies, CGM significantly reduces HbA 1c by about 0.5% as compared to intermittent SMBG, provided that the patient uses CGM at least 40% of the prescribed time [19,[23][24][25][26]. The results of these studies are detailed in Table 2.…”

“…In intention to treat (ITT), the results are significant in 7 studies in patients with good or bad glucose control at baseline [11,35]. In several studies, the improvement in HbA 1c is comparable in children or adolescents and adults [23,31,32,50]. This is not the case in the paediatric groups in the JDRF study [24]: compared to adults, the paediatric population had less good adherence to the use of sensors (83% of adults vs 50% of children and 30% of adolescents).…”

“…When the results are analysed in terms of adherence to the use of sensors (analysis per protocol), the decrease in HbA 1c is significant whatever the age (on average -0.53%, ranging from -0.3 to -0.8%). The rate of paediatric patients having an optimal adherence in these studies varies considerably, from 15-20% (in the JRDF adolescent group and the DirecNet group of very young children) to more than 70% [23,50].…”