Glucose Monitoring Devices Help Reduce Long-Term Risks of Diabetes

People with type 1 diabetes who have already been successful in achieving recommended blood sugar goals can further benefit from using continuous glucose monitoring (CGM) devices, according to a new study.

Researchers at the Juvenile Diabetes Research Foundation (New York, NY, USA) conducted a randomized and controlled trial involving 129 adults and children ranging from 8 to 69 years of age at ten different sites, and coordinated by the Jaeb Center for Health Research (Tampa, FL, USA). All participants had good diabetes control when they enrolled in the trial, and were randomly assigned to either a group that used CGM devices or one using standard finger-stick glucose testing for 26 weeks. The main study outcomes were time with glucose level lower than 70 mg/dL, severe hypoglycemic events, and glycated hemoglobin (HbA1c) level, a good measure of long-term blood sugar control.

The researchers found that for the people using CGM devices, the time the blood sugar level was below 70 mg/dL decreased by 37 minutes a day; this compared with a decrease in the control group of only 5 minutes a day. The people in the CGM group spent almost two hours more time per day in the target blood sugar range of 71 to 180 mg/dL compared with the control group, and about half an hour less time per day with glucose values in the potentially dangerous hypoglycemia range. A number of other significant benefits were demonstrated, including an improvement in HbA1c of more than 0.3% (31% in the CGM group versus 5% in the control group); fewer worsening of HbA1c greater than 0.3% (28% versus 52%); more CGM users had a HbA1c level below 7% at 26 weeks (88% versus 63%); and more people in the CGM group than the control group had a decrease in HbA1c of more than 0.3% without experiencing a severe hypoglycemic event (28% versus 5%). Encouragingly, similar beneficial results were seen in children, adolescents, and adults, spanning all ages. The study was published online on May 28, 2009, in the journal Diabetes Care.

"The research suggests that CGM devices helped people who were already doing an excellent job of managing their diabetes continue to do so,” said lead author Bruce Bode, M.D., of the Atlanta Diabetes Associates (GA, USA). "These trials are showing that CGM not only helps people get into control, which can have a significant positive impact on lowering the risk of complications, but it enables them to stay in control without increasing the near-term risk of hypoglycemia. That's terrific news for people with diabetes and their families.”

Diabetics try to maintain their blood sugar levels between 70 mg/dL and 180 mg/dL. If blood sugar levels are very low, people can become confused, lethargic, and even slip into a coma or die; conversely, very high blood sugars can also be dangerous. Long-term lack of control increases the risk of developing devastating complications, including eye, kidney, nerve, and heart disease. HbA1c standards of good control are generally below 7% for adults and below 7.5% to 8% for children, depending on age. Every one-point reduction in HbA1c reduces the risk of long-term complications by approximately 40%.

Reletaed Links:
Juvenile Diabetes Research Foundation
Jaeb Center for Health Research
Atlanta Diabetes Associates