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

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Charleer, Sara Mathieu, Chantal Nobels, Frank De Block, Christophe Radermecker, Regis P Hermans, Michel [UCL] RESCUE Trial Investigators

(eng) 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: A total of 515 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 1, 2014, and December 31, 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 with 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, whereas work absenteeism and admissions for acute diabetes complications decreased. TRIAL REGISTRATION: ClinicalTrials.gov NCT02601729.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2018
Language Anglais
Journal information "The Journal of Clinical Endocrinology & Metabolism" - Vol. 103, no. 3, p. 1224-1232 (2018)
Peer reviewed yes
Publisher Oxford University Press ((United States) New York, NY)
issn 0021-972X
e-issn 1945-7197
Publication status Publié
Affiliations UCL - (SLuc) Service d'endocrinologie et de nutrition
UCL - SSS/IREC/EDIN - Pôle d'endocrinologie, diabète et nutrition
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Bibliographic reference Charleer, Sara ; Mathieu, Chantal ; Nobels, Frank ; De Block, Christophe ; Radermecker, Regis P ; et. al. Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions, and Quality of Life: A Real-World Study. In: The Journal of Clinical Endocrinology & Metabolism, Vol. 103, no. 3, p. 1224-1232 (2018)
Permanent URL http://hdl.handle.net/2078.1/215745