The Effect of Discontinuing Continuous Glucose Monitoring in Adults With Type 2 Diabetes Treated With Basal Insulin
Grazia Aleppo, Roy W. Beck, Ryan Bailey, Katrina J. Ruedy, Peter Calhoun, Anne L. Peters, Rodica Pop‐Busui, Athena Philis‐Tsimikas, Shichun Bao, Guillermo E. Umpierrez, Georgia M. Davis, Davida Kruger, Anuj Bhargava, Laura Young, John B. Buse, Janet B. McGill, Thomas Martens, Quang T. Nguyen, Ian J. Orozco, William Biggs, K. Lucas, William H. Polonsky, David A. Price, Richard M. Bergenstal, MOBILE Study Group, Thomas Martens, Anders L. Carlson, Richard M. Bergenstal, Sharon Chambers, Shoua Yang, Laura Young, John B. Buse, M. Sue Kirkman, Alexander Kass, Rachael Fraser, Davida Kruger, Terra Cushman, Georgia M. Davis, Clementina Ramos, Guillermo Umpierrez, Anne L. Peters, Maria Magar, Martha Walker, Sara Serafin-Dokhan, Janet B. McGill, Maamoun Salam, Stacy Hurst, Mary Jane Clifton, Grazia Aleppo, Jelena Kravarusic, Anupam Bansal, Candice Fulkerson, Rodica Pop-Busui, Lynn Ang, Caroline R. Richardson, Kara Mizokami‐Stout, Jake Reiss, Virginia Leone, Anuj Bhargava, Kirstie Stifel, Athena Philis‐Tsimikas, George Dailey, Amy Change, James McCallum, María Isabel Ávalos García, Shichun Bao, Dianne Davis, C. Lovell, Connie Root, William Biggs, Freida Toler, Lori Wilhelm, Robin Eifert, Lorena Murguia, Becky Cota, Quang T. Nguyen, Loida Nguyen, Randie Lipski, Ian J. Orozco, Mary Katherine Lawrence, Adelle Fournier, Matthew Carter, K. Jean Lucas, Stephanie Hoover, Roy W. Beck, Katrina J. Ruedy, Peter Calhoun, Ryan Bailey, Nathan Cohen, Thomas J. Mouse, Jessica Rusnak, Tiffany Campos, David Price, Nelly M. Njeru, Tom Arant, Stayce E. Beck, Andrew K. Balo
Abstract
OBJECTIVE To explore the effect of discontinuing continuous glucose monitoring (CGM) after 8 months of CGM use in adults with type 2 diabetes treated with basal without bolus insulin. RESEARCH DESIGN AND METHODS This multicenter trial had an initial randomization to either real-time CGM or blood glucose monitoring (BGM) for 8 months followed by 6 months in which the BGM group continued to use BGM (n = 57) and the CGM group was randomly reassigned either to continue CGM (n = 53) or discontinue CGM with resumption of BGM for glucose monitoring (n = 53). RESULTS In the group that discontinued CGM, mean time in range (TIR) 70–180 mg/dL, which improved from 38% before initiating CGM to 62% after 8 months of CGM, decreased after discontinuing CGM to 50% at 14 months (mean change from 8 to 14 months −12% [95% CI −21% to −3%], P = 0.01). In the group that continued CGM use, little change was found in TIR from 8 to 14 months (baseline 44%, 8 months 56%, 14 months 57%, mean change from 8 to 14 months 1% [95% CI −11% to 12%], P = 0.89). Comparing the two groups at 14 months, the adjusted treatment group difference in mean TIR was −6% (95% CI −16% to 4%, P = 0.20). CONCLUSIONS In adults with type 2 diabetes treated with basal insulin who had been using real-time CGM for 8 months, discontinuing CGM resulted in a loss of about one-half of the initial gain in TIR that had been achieved during CGM use.