Sustained Reduction in Severe Hypoglycemia in Adults With Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia: Two-Year Follow-up in the HypoCOMPaSS Randomized Clinical Trial

Little, Sally A.; Speight, Jane; Leelarathna, Lalantha; Walkinshaw, Emma; Tan, Horng Kai; Bowes, Anita; Lubina-Solomon, Alexandra; Chadwick, Thomas; Stocken, Deborah; Brennand, Catherine; Marshall, Sally M.; Wood, Ruth; Kerr, David; Flanagan, Daniel; Heller, Simon; Evans, Mark; Shaw, James

doi:10.2337/dc17-2682

Cited by 69 publications

(70 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therefore, the device represents a cost-effective measure to reducing hypoglycemia, particularly in high-risk groups of patients. Moreover, these data further support the use of continuous glucose data to reduce hypoglycemia in diabetes 2–4 19 20…”

Section: Resultssupporting

confidence: 58%

Flash glucose monitoring improves glycemia in higher risk patients: a longitudinal, observational study under real-life settings

Jangam

Dunn²,

Xu³

et al. 2019

BMJ Open Diab Res Care

View full text Add to dashboard Cite

ObjectiveTo assess the role of flash glucose monitoring in early and late changes in glycemic markers under real-life conditions.Research design and methodsDeidentified glucose results from 6802 flash glucose monitors were analyzed after dividing into high, medium and low-risk groups based on tertiles of time spent in hypoglycemia (min/day <70 mg/dL) or hyperglycemia (hours/day >240 mg/dL). Groups were further subdivided into tertiles of glucose scanning frequency and glycemic measures analyzed in the first 14 days and over 6 months.ResultsImprovement in dysglycemia mainly occurred in the first month of device use. Comparing first and last 14 study days, high-hyperglycemic-risk individuals showed reduced time >240 mg/dL (mean±SEM) from 6.07±0.06 to 5.73±0.09 hours/day (p<0.0001). High-frequency scanners showed 0.82 hours/day reduction in hyperglycemia (p<0.0001) whereas low-frequency scanners failed to demonstrate a benefit. High-hypoglycemic-risk individuals showed reduction in time ≤54 mg/dL from 90±1 to 69±2 min/day (p<0.0001) comparing first and last 14 study days. This reduction was evident in both low and high-frequency scanners but with reduced hyperglycemic exposure in the latter group.ConclusionsUnder real-world conditions, flash monitoring is associated with rapid and sustained reduction in dysglycemia with high-frequency scanners demonstrating more significant reduction in hyperglycemia.

show abstract

Section: Resultssupporting

confidence: 58%

Flash glucose monitoring improves glycemia in higher risk patients: a longitudinal, observational study under real-life settings

Jangam

Dunn²,

Xu³

et al. 2019

BMJ Open Diab Res Care

View full text Add to dashboard Cite

show abstract

“…For example, a UK-based structured education program, Dose Adjustment for Normal eating (DAFNE), restores awareness in 43% of people with impaired awareness of hypoglycaemia [27]. Similarly, the HypoCOMPaSS trial showed that education around the prompt treatment of hypoglycaemia was as important as technologies such as insulin pump therapy and glucose sensors [28]. • Insulin pumps and continuous glucose sensors: insulin pump therapy, particularly sensor-augmented insulin pumps, has a role in reducing severe hypoglycaemia and restoring unawareness [29].…”

Section: Reversing Hypoglycaemic Unawarenessmentioning

confidence: 99%

Symptoms of Hypoglycaemia

Loumpardia¹,

Huda²

2020

Blood Glucose Levels

View full text Add to dashboard Cite

Hypoglycaemia is common in clinical practice for people with diabetes. However, the symptoms can vary between individuals and at different stages of their condition. Moreover, several factors influence symptoms experienced by people with diabetes, and many are amenable to intervention. Symptoms are commonly neuroglycopenic or neurogenic in aetiology, and these lead to different clusters of symptoms. Certain patient groups such as the elderly and pregnant women are particularly susceptible to hypoglycaemia. In this chapter, we describe the physiology and pathophysiology behind the symptoms of hypoglycaemia, with reference to current knowledge from neuroimaging studies, and outline potential interventions to modify or restore hypoglycaemia symptoms.

show abstract

“…Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial Feig DS 1,2,3 , Donovan LE 4 , Corcoy R 5 , Murphy KE 2,3,6 , Amiel SA 7 , Hunt KF 7,8 , Asztalos E 9 , Barrett JFR 9 , Sanchez JJ 9 , de Leiva A 5 , Hod M 10 , Jovanovic L 11,12 , Keely E 13 This manuscript is also discussed in the article on Technology and Pregnancy, page S-101.…”

Section: Commentsmentioning

confidence: 99%

Continuous Glucose Monitoring in 2018

Bode

Battelino

2019

Diabetes Technology & Therapeutics

View full text Add to dashboard Cite

A dvanced treatment modalities are generally associated with considerable additional costs for the payer. As the costs of medical care for diabetes represent an increasing share in most health-care budgets (1), payers design various strategies to limit the access to expensive treatment modalities. It is exceedingly rare that a novel, efficient, and safe treatment modality can incur cost reduction. Continuous glucose monitoring (CGM) seems to position itself into this uncommon category (2). Now unequivocally accepted as safe and efficient, and recommended in all clinical guidelines from all professional associations (3), CGM enters various public and private insurance systems with the proven potential to reduce acute morbidity and absenteeism, adding considerably to the total reduction of costs related to diabetes. The current article discusses recent clinical evidence associating CGM with reduction in morbidity related to glucose variability and hyper-and hypoglycemia, with the focus on well-being of people with diabetes (PWD) and, during pregnancy complicated by diabetes, also on their offspring. Indeed, CGM is ''transforming diabetes management step by step'' (4), among PWD as well as diabetes care providers. The CGM metric of time in target range (TIR) becomes more widely adopted, and its use combined with time in hypoglycemia can provide a more personalized approach to diabetes management. As always, PWD will have to decide whether CGM is their ''best friend or spy'' (5). CGM influences physical, emotional, and relational aspects of everyday life. Diabetes care providers can help reduce the burden of CGM with sensible delivered training and realistic expectations for PWD. Complementing the quality of life (QOL) outcomes in adults with diabetes, CGM use has been associated with less adolescent and parental distress compared to no technology use, along with lower glycosylated hemoglobin (HbA1c) (6). Empowerment and relational partnerships in diabetes care can optimize contentment and success with CGM. PWD seem to be perfectly ready-let's make sure that we, diabetes care providers, don't lag behind.

show abstract

Sustained Reduction in Severe Hypoglycemia in Adults With Type 1 Diabetes Complicated by Impaired Awareness of Hypoglycemia: Two-Year Follow-up in the HypoCOMPaSS Randomized Clinical Trial

Abstract: Optimized insulin replacement and glucose monitoring underpinned by hypoglycemia-focused structured education should be provided to all with type 1 diabetes complicated by impaired awareness of hypoglycemia.

Cited by 69 publications

References 33 publications

Flash glucose monitoring improves glycemia in higher risk patients: a longitudinal, observational study under real-life settings

Flash glucose monitoring improves glycemia in higher risk patients: a longitudinal, observational study under real-life settings

Symptoms of Hypoglycaemia

Continuous Glucose Monitoring in 2018

Contact Info

Product

Resources

About