Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions and Quality of Life: A Real-World Study.

Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions and Quality of Life: A Real-World Study.

J Clin Endocrinol Metab. 2018 Jan 12;:

Authors: Charleer S, Mathieu C, Nobels F, De Block C, Radermecker RP, Hermans MP, Taes Y, Vercammen C, T'Sjoen G, Crenier L, Fieuws S, Keymeulen B, Gillard P, RESCUE trial investigators

Abstract
Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use.
Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism and quality of life (QOL).
Design: Prospective, observational, multicenter, cohort study.
Participants: Five hundred fifteen adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program.
Intervention: Initiation of RT-CGM reimbursement.
Main Outcome Measure: Hemoglobin A1c (HbA1c) evolution from baseline to 12 months.
Results: Between September 1th, 2014, and December 31th, 2016, 515 adults entered the reimbursement system. Over this period, 417 (81%) patients used RT-CGM for at least 12 months. Baseline HbA1c was 7.7±0.9% (61±9.8 mmol/mol) and decreased to 7.4±0.8% (57±8.7 mmol/mol) at 12 months (P<0.0001). Subjects who started RT-CGM because of insufficient glycemic control showed stronger decrease in HbA1c at 4, 8 and 12 months compared to patients who started because of hypoglycemia or pregnancy. In the year preceding reimbursement, 16% of patients were hospitalized for severe hypoglycemia or ketoacidosis in contrast to 4% (P<0.0005) the following year with decrease in admission days from 54 to 18 per 100 patient-years (P<0.0005). In the same period, work absenteeism decreased, and QOL improved significantly, with strong decline in fear of hypoglycemia.
Conclusion: Sensor-augmented pump therapy in patients with T1D followed in specialized centers improves HbA1c, fear of hypoglycemia and QOL while work absenteeism and admissions for acute diabetes complications decreased.

PMID: 29342264 [PubMed - as supplied by publisher]

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