Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial

Associations between HbA1c and continuous glucose monitoring‐derived glycaemic variables

“…The REPLACE-BG study [11] enrolled participants with well-controlled Type 1 diabetes and compared the safety and efficacy of CGM used as an adjunct to self-monitoring of blood glucose to that of CGM used nonadjunctively for therapeutic decisions. The HypoDE study [12] enrolled participants with Type 1 diabetes and a history of impaired hypoglycaemia awareness or severe hypoglycaemia, and studied the effectiveness of real-time CGM for reducing the number of hypoglycaemic events. All of these studies lasted at least 24 weeks and used current or recent-generation CGM systems (G4 Platinum or G5 Mobile; Dexcom, Inc., San Diego, CA, USA).…”

Use of sensor‐integrated pump therapy to reduce hypoglycaemia in people with Type 1 diabetes: a real‐world study in the UK

“…In participants who switched from SAP to LGM (n=31), the monthly rate of sensor hypoglycaemic events <3 mmol/l decreased by 37% (model-based event rate ratio 0.63, 95% CI 0.45-0.89; P =0.009), and the median (25 th -75 th percentile) percentage of time spent with glucose values ≤3 mmol/l was also reduced: SAP 0.63 (0.34-1.29)%; LGS 0.33 The median (25th-75th percentile) time per day with blood glucose ≤3 mmol/l was significantly lower in the LGS period, compared with the SAP period (5.0 [2][3][4][5][6][7][8][9] min vs 9.0 [5][6][7][8][9] min, respectively; P=0.001), as were the corresponding times with sensor glucose ≤3.9 mmol/l (38.0 min vs 57 [37-76] min, respectively; P=0.0028). Thus, LGS was associated with 44% less time spent with glucose ≤30 mmol/ l, and 33% less time ≤3.9 mmol/l, compared with SAP.…”

“…In recent years, the management of Type 1 diabetes has been transformed by continuous glucose monitoring (CGM), which can be used with or without insulin pump therapy. Although CGM alone can potentially improve glycaemic control and reduce hypoglycaemia [4,5], sensor-integrated pump therapy, which combines continuous subcutaneous insulin infusion (CSII) with real-time CGM, offers the opportunity for automated insulin suspension to prevent or minimize the risk of harm resulting from hypoglycaemia. This approach has been shown to provide improved glycaemic control compared with CSII or multiple daily injections with self-monitoring of blood glucose, but its effects on the rate of severe hypoglycaemia have been less consistent [6][7][8][9].…”

Glycaemic variability: The under‐recognized therapeutic target in type 1 diabetes care

“…During the past few years there has been an exponential rise in the use of CGM systems; uptake has increased from 7% to 30% from 2010/12 to 2016/18 in the cohort followed in the T1D Exchange trial in the USA . The ability to check and react to glucose readings more frequently, and the existence of alarms that warn users of high or low glucose values, lead to benefits in glucose control, typically a 0.3%‐0.5% reduction in HbA1c and a significant reduction in the incidence of hypoglycaemia …”