Intermittently Scanned CGM Positively Impacts Glycemic Control in Diabetics

People with type 1 diabetes (T1D) who use intermittently scanned continuous glucose monitoring (isCGM) devices report higher treatment satisfaction, quality of life (QOL), and less severe hypoglycemia, according to a new study.

Researchers at Katholieke Universiteit Leuven (KU; Belgium), the University of Antwerp (Belgium), and other institutions conducted a 12-month prospective observational study to investigate the impact of isCGM on QOL and glycemic control in 1,913 adults with T1D who were consecutively recruited in three specialist diabetes centers in Belgium. The primary end point was evolution of QOL from baseline to 12 months, with secondary outcomes including change in hemoglobin A1C (HbA1c), time spent in different glycemic ranges, acute diabetes complications, and work absenteeism.

The results showed that HbA1c levels remained stable, as did the participants general and diabetes-specific QOL; treatment satisfaction improved during the study period. While rare, admissions for severe hypoglycemia and/or ketoacidosis decreased, reports of severe hypoglycemic events fell (14.6% versus 7.8%), as did hypoglycemic comas (2.7% versus 1.1%). Absences from work fell by 50%, but 11% of study participants experienced adverse skin reactions, leading to about one percent stopping isCGM. The study was published on December 24, 2019, in Diabetes Care.

“In 2016, nationwide reimbursement of intermittently scanned continuous glucose monitoring for people living with type one diabetes treated in specialist diabetes centers was introduced in Belgium,” concluded lead author Sara Charleer, MSc, of KU, and colleagues. “Unrestricted reimbursement results in higher treatment satisfaction, less severe hypoglycemia, and less work absenteeism, while maintaining quality of life and HbA1c.”

The isCGM device used for the study was the Abbott (Abbott Park, IL, USA) Freestyle Libre system, which continuously samples and measures interstitial glucose levels; a new glucose value is generated each minute. The sensor can provide glucose values for 14 days if the patient scans at least every 8 hours. If not, the glucose information from the previous 8-hour period will be overwritten and will not available for therapy decision-making or for later download. Unlike real time CGM devices, the Libre is factory-calibrated, which eliminates the need for daily calibration with fingerstick testing.

Related Links:
Katholieke Universiteit Leuven
University of Antwerp
Abbott