A study suggested that continuous glucose monitoring will be beneficial even when patients with type 1 diabetes have excellent hemoglobin A1C levels.
The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group conducted a study involved 129 children and adults with type 1 diabetes who were maintaining their A1C levels below 7.0% with intensive insulin therapy.
In the study, participants were assigned randomly either to continuous glucose monitoring with an insulin pump (n=67) or to standard home monitoring (n=62) with a blood glucose meter and test strips, with testing done at least 4 times daily.
Dr. Roy W. Beck from the Jaeb Center for Health Research in Tampa, Florida and his co-authors reported that the major limiting factor for achieving euglycemia in patients with type 1 diabetes is hypoglycemia.
Moreover, the investigators observed that median time with a glucose level of 60 mg/dL or lower was significantly less in the continuous monitoring group (18 min/d vs 35 min/d with standard monitoring, p=0.05).
Time out of range, 70 mg/dL or less, or > 180 mg/dL, was also evidently lower with continuous monitoring (377 min/d) than with standard monitoring (491 min/d, p = 0.003).
There was no difference between groups, however, in the number of patients who had at least one severe hypoglycemic event.
There was a significant difference in mean A1C level favoring the continuous monitoring group (6.4 vs 6.8, p < 0.001) over 26 weeks. In addition, more subjects in the continuous monitoring group had A1C levels below 7.0% (88% vs 63%, p < 0.001).
Based on the weight of evidence, the authors conclude, continuous glucose monitoring is beneficial for adults and children with type 1 diabetes who already have achieved excellent control with home glucose monitoring.