Use of intermittently scanned continuous glucose monitoring in young people with high‐risk type 1 diabetes—Extension phase outcomes following a 6‐month randomized control trial
Shelley Rose, Sara E. Styles, Esko Wiltshire, James Stanley, Barbara C. Galland, Martin de Bock, Paul A. Tomlinson, Jenny Rayns, Karen E. MacKenzie, Benjamin J. Wheeler
Abstract
Abstract Aims To describe the impact of a 12‐month intervention using intermittently scanned continuous glucose monitoring (isCGM) on glycaemic control and glucose test frequency in adolescents and young adults with type 1 diabetes (T1D) and high‐risk glycaemic control (HbA 1c ≥75 mmol/mol [≥9.0%]). Methods In total, 64 young people (aged 13–20 years, 16.6 ± 2.1 years; 48% female; 41% Māori or Pacific ethnicity; mean diabetes duration 7.5 ± 3.8 years) with T1D were enrolled in a 6‐month, randomized, parallel‐group study comparing glycaemic outcomes from the isCGM intervention ( n = 33) to self monitoring blood glucose (SMBG) controls ( n = 31). In this 6‐month extension phase, both groups received isCGM; HbA 1c , glucose time‐in‐range (TIR), and combined glucose test frequency were assessed at 9 and 12 months. Results At 12 months, the mean difference in HbA 1c from baseline was −4 mmol/mol [−0.4%] (95% confidence interval, CI: −8, 1 mmol/mol [−0.8, 0.1%]; p = 0.14) in the isCGM intervention group, and −7 mmol/mol [−0.7%] (95% CI: −16, 1 mmol/mol [−1.5, 0.1%]; p = 0.08) in the SMBG control group. No participants achieved ≥70% glucose TIR (3.9–10.0 mmol/L). The isCGM intervention group mean rate of daily glucose testing was highest at 9 months, 2.4 times baseline rates ( p < 0.001), then returned to baseline by 12 months (incidence rate ratio = 1.4; 95% CI: 0.9, 2.1; p = 0.091). Conclusions The use of isCGM in young people with high‐risk T1D resulted in transient improvements in HbA 1c and glucose monitoring over a 9‐month time frame; however, benefits were not sustained to 12 months.