Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

Abstract

Flash glucose monitoring (FGM) was introduced in China in 2016, and it might improve HbA1c measurements and reduce glycaemic variability during T1DM therapy. A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. The patients were randomly divided into the FGM group or self-monitoring blood glucose (SMBG) group. Both groups wore the FGM device for multiple 2-week periods, beginning with the 1st, 24th, and 48th weeks for gathering data, while blood samples were also collected for HbA1c measurement. Dietary guidance and insulin dose adjustments were provided to the FGM group patients according to their Ambulatory Glucose Profile (AGP) and to the SMBG group patients according to their SMBG measurements taken 3–4 times daily. All of the participants underwent SMBG measurements on the days when not wearing the FGM device. At the final visit, HbA1c, time in range (TIR), duration of hypoglycaemia and the number of diabetic ketoacidosis (DKA) events were taken as the main endpoints. There were no significant difference in the baseline characteristics of the two groups. At 24 weeks, the HbA1c level of the FGM group was 8.16 ± 1.03%, which was much lower than that of the SMBG group (8.68 ± 1.01%) (p = 0.003). The interquartile range (IQR), mean blood glucose (MBG), and the duration of hypoglycaemia in the FGM group also showed significant declines, compared with the SMBG group (p < 0.05), while the TIR increased in the FGM group [(49.39 ± 17.54)% vs (42.44 ± 15.49)%] (p = 0.012). At 48 weeks, the differences were more pronounced (p < 0.01). There were no observed changes in the number of episodes of DKA by the end of the study [(0.25 ± 0.50) vs (0.28 ± 0.51), p = 0.75]. Intermittent use of FGM by T1DM patients can improve their HbA1c and glycaemic control without increasing the hypoglycaemic exposure in insulin-treated individuals with type 1 diabetes in an developing country.

Validity of Danish public criteria for providing flash glucose monitoring to participants with type 1 diabetes—An explorative cohort study

“…Our study was not designed to demonstrate FGM efficacy of improving blood glucose regulation. We note, however, the lack of change in average TIR, TBR, HbA1c, and number of daily scans, well knowing other studies describes inconsistency and small reduction of HbA1c with FGM 2–5,7–10 …”

“…We note, however, the lack of change in average TIR, TBR, HbA1c, and number of daily scans, well knowing other studies describes inconsistency and small reduction of HbA1c with FGM. [2][3][4][5][7][8][9][10] Some patients do improve their glucose levels on FGM.…”

Effect of the Chinese New Year Public Holiday on the Glycemic Control of T1DM With Intensive Insulin Therapy

“…However, the present study only reported the changes in glycemic indices before, during and after the Chinese New Year public holiday in T1DM patients using the FGM system. Continuous glucose monitoring is superior to self-monitoring of blood glucose in improving glycemic control among individuals with T1DM ( 16 , 17 ).However, the annual cost of FGM for T1DM individuals is 13,372 Chinese Yuan, while the cost of self-monitoring blood glucose levels is only 3675 Chinese Yuan ( 17 ). Previous research has shown suboptimal adherence to the treatment regimen and significantly fewer self-monitored blood glucose readings during the holidays in T1DM patients with self-monitoring of blood glucose ( 12 ).…”

Use of continuous glucose monitors in low‐ and middle‐income countries: A scoping review

“…China contributed with seven studies, [16][17][18][19][20][21][22] Colombia with five, [23][24][25][26][27] India with four, [28][29][30][31] Brazil [32][33][34] and Turkey [35][36][37] with three each, and Argentina, 38 Bosnia and Herzegovina, 39 Georgia, 40 Malaysia 41 and Mexico, 42 with one study each (Table 1). Only one report was published in 2002, 32 and the number of reports per year increased steadily, reaching eight reports in 2021, [17][18][19]22,26,31,40,42 and five reports up to July 2022. 20,30,34,36,38 Overall, seven reports presented results of experimental studies (five randomized trials and two quasiexperimental [pre-post]) 16,17,19,22,27,41,…”

“…Only one report was published in 2002, 32 and the number of reports per year increased steadily, reaching eight reports in 2021, [17][18][19]22,26,31,40,42 and five reports up to July 2022. 20,30,34,36,38 Overall, seven reports presented results of experimental studies (five randomized trials and two quasiexperimental [pre-post]) 16,17,19,22,27,41,42 ; two reports focused on cost-effective analysis 23,37 and the remaining 18 were observational in nature. The number of participants in the studies varied between 20 and 5072, whereas follow-up time ranged from 14 days to 18 months.…”