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Clínic Barcelona

Continuous glucose monitoring enhances glucose control in type 1 diabetes

Near normoglycaemia is associated with a reduced risk of microvascular and macrovascular complications in type 1 diabetes. It is one of the main targets for patients and healthcare providers, because despite considerable effort only a minority of patients achieve normoglycaemia. Researchers from IDIBAPS – Hospital Clínic of Barcelona have participated in a recently published work in Diabetologia showing that continuous glucose monitoring is better to control glucose levels in type 1 diabetes when compared to the traditional insulin pump therapy. Dr. Ignacio Conget, from the Diabetes Unit, Endocrinology Department at IDIBAPS – Hospital Clínic, is the second author of this multicentre, randomised, controlled crossover study.

Over 150 patients were recruited for the study, including paediatric and adult patients. They were randomised to a continuous glucose monitoring Sensor On or Sensor Off group for 6 months. After 4 months’ washout, participants crossed over to the other arm for 6 months. HbA1c was the lab test used to control how well patients are controlling their diabetes. It shows the average level of blood glucose over the previous 3 months. The primary outcome of the study was the difference in HbA1c levels between arms after 6 months.

The results indicated a mean difference in HbA1c of –0.43% (–4.74 mmol/mol) in favour of the Sensor On group. While the Sensor was On, less time was spent with sensor glucose

In conclusion, in both paediatric and adult participants with type 1 diabetes using insulin pump therapy alone, the addition of continuous glucose monitoring resulted in an improvement in HbA1c with a decrease in time spent in hypoglycaemia. More frequent self-adjustments of insulin therapy with sensor-augmented insulin pump therapy may have contributed to these effects. The removal of continuous glucose monitoring resulted in a loss of metabolic benefit.