The Effect of Do-It-Yourself Real-Time Continuous Glucose Monitoring on Glycemic Variables and Participant-Reported Outcomes in Adults With Type 1 Diabetes: A Randomized Crossover Trial-Reference-Cited by-同舟云学术

The Effect of Do-It-Yourself Real-Time Continuous Glucose Monitoring on Glycemic Variables and Participant-Reported Outcomes in Adults With Type 1 Diabetes: A Randomized Crossover Trial

Published:2023-09-06 Issue: Volume: Page:
ISSN:1932-2968
Container-title:Journal of Diabetes Science and Technology
language:en
Short-container-title:J Diabetes Sci Technol

Author:

Sehgal Shekhar¹^ORCID,Elbalshy Mona¹,Williman Jonathan²,Galland Barbara¹,Crocket Hamish³,Hall Rosemary⁴,Paul Ryan³,Leikis Robert⁵,de Bock Martin²^ORCID,Wheeler Benjamin J.¹^ORCID

Affiliation:

1. Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

2. Department of Paediatrics, Canterbury District Health Board, Christchurch, New Zealand

3. Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand

4. Te Whatu Ora, Capital, Coast and Hutt Valley, Wellington, New Zealand

5. Te Whatu Ora, Hawke’s Bay, Hastings, New Zealand

Abstract

Aim: Real-time continuous glucose monitoring (rtCGM) has several advantages over intermittently scanned continuous glucose monitoring (isCGM) but generally comes at a higher cost. Do-it-yourself rtCGM (DIY-rtCGM) potentially has benefits similar to those of rtCGM. This study compared outcomes in adults with type 1 diabetes using DIY-rtCGM versus isCGM. Methods: In this crossover trial, adults with type 1 diabetes were randomized to use isCGM or DIY-rtCGM for eight weeks before crossover to use the other device for eight weeks, after a four-week washout period where participants reverted back to isCGM. The primary endpoint was time in range (TIR; 3.9-10 mmol/L). Secondary endpoints included other glycemic control measures, psychosocial outcomes, and sleep quality. Results: Sixty participants were recruited, and 52 (87%) completed follow-up. Glucose outcomes were similar in the DIY-rtCGM and isCGM groups, including TIR (53.1% vs 51.3%; mean difference −1.7% P = .593), glycosylated hemoglobin (57.0 ± 17.8 vs 61.4 ± 12.2 mmol/L; P = .593), and time in hypoglycemia <3.9 mmol/L (3.9 ± 3.8% vs 3.8 ± 4.0%; P = .947). Hypoglycemia Fear Survey total score (1.17 ± 0.52 vs 0.97 ± 0.54; P = .02) and fear of hypoglycemia score (1.18 ± 0.64 vs 0.97 ± 0.45; P = .02) were significantly higher during DIY-rtCGM versus isCGM. Diabetes Treatment Satisfaction Questionnaire status (DTSQS) score was also higher with DIY-rtCGM versus isCGM (28.7 ± 5.8 vs 26.0 ± 5.8; P = .04), whereas diabetes-related quality of life was slightly lower (DAWN2 Impact of Diabetes score: 3.11 ± 0.4 vs 3.32 ± 0.51; P = .045); sleep quality did not differ between the two groups. Conclusion: Although the use of DIY-rtCGM did not improve glycemic outcomes compared with isCGM, it positively impacted several patient-reported psychosocial variables. DIY-rtCGM potentially provides an alternative, cost-effective rtCGM option.

Funder

Health Research Council of New Zealand

Publisher

SAGE Publications

Subject

Biomedical Engineering,Bioengineering,Endocrinology, Diabetes and Metabolism,Internal Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/19322968231196562

Reference33 articles.

1. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview

2. State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016–2018

3. Clinical review: the misreporting of logbook, download, and verbal self-measured blood glucose in adults and children with type I diabetes

4. National Institutes of Clinical Excellence. Type 1 diabetes in adults: diagnosis and management, 2022. Available at: https://www.nice.org.uk/guidance/ng17. Accessed December, 2022.