Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes

TitleFactors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes
Publication TypeJournal Article
Year of Publication2009
AuthorsBeck, R. W., Buckingham B., Miller K., Wolpert H., Xing D., Block J. M., Chase H. P., Hirsch I., Kollman C., Laffel L., Lawrence J. M., Milaszewski K., Ruedy K. J., & Tamborlane W. V.
Corporate AuthorsJuvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group
JournalDiabetes Care
Volume32
Issue11
Pagination1947-53
Date Published2009 Nov
ISSN1935-5548
KeywordsAdolescent; Adult; Aged; Blood Glucose; Child; Diabetes Mellitus, Type 1; Follow-Up Studies; Hemoglobin A, Glycosylated; Humans; Hypoglycemic Agents; Insulin; Insulin Infusion Systems; Middle Aged; Monitoring, Ambulatory; Patient Selection
Abstract

OBJECTIVE: To evaluate factors associated with successful use of continuous glucose monitoring (CGM) among participants with intensively treated type 1 diabetes in the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Randomized Clinical Trial.
RESEARCH DESIGN AND METHODS: The 232 participants randomly assigned to the CGM group (165 with baseline A1C >or=7.0% and 67 with A1C <7.0%) were asked to use CGM on a daily basis. The associations of baseline factors and early CGM use with CGM use >or=6 days/week in the 6th month and with change in A1C from baseline to 6 months were evaluated in regression models.
RESULTS: The only baseline factors found to be associated with greater CGM use in month 6 were age >or=25 years (P < 0.001) and more frequent self-reported prestudy blood glucose meter measurements per day (P < 0.001). CGM use and the percentage of CGM glucose values between 71 and 180 mg/dl during the 1st month were predictive of CGM use in month 6 (P < 0.001 and P = 0.002, respectively). More frequent CGM use was associated with a greater reduction in A1C from baseline to 6 months (P < 0.001), a finding present in all age-groups.
CONCLUSIONS: After 6 months, near-daily CGM use is more frequent in intensively treated adults with type 1 diabetes than in children and adolescents, although in all age-groups near-daily CGM use is associated with a similar reduction in A1C. Frequency of blood glucose meter monitoring and initial CGM use may help predict the likelihood of long-term CGM benefit in intensively treated patients with type 1 diabetes of all ages.




DOI10.2337/dc09-0889
Alternate JournalDiabetes Care
Refereed DesignationRefereed