TY - JOUR
T1 - Effect of Continuous Glucose Monitoring on Glycemic Control, Acute Admissions and Quality of Life
T2 - A Real-World Study
AU - Charleer, Sara
AU - Mathieu, Chantal
AU - Nobels, Frank
AU - De Block, Christophe
AU - Radermecker, Regis P
AU - Hermans, Michel P
AU - Taes, Youri
AU - Vercammen, Chris
AU - T'Sjoen, Guy
AU - Crenier, Laurent
AU - Fieuws, Steffen
AU - Keymeulen, Bart
AU - Gillard, Pieter
AU - RESCUE trial investigators
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use.Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism, and quality of life (QOL).Design: Prospective, observational, multicenter, cohort study.Participants: A total of 515 adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program.Intervention: Initiation of RT-CGM reimbursement.Main Outcome Measure: Hemoglobin A1c (HbA1c) evolution from baseline to 12 months.Results: Between September 1, 2014, and December 31, 2016, 515 adults entered the reimbursement system. Over this period, 417 (81%) patients used RT-CGM for at least 12 months. Baseline HbA1c was 7.7 ± 0.9% (61 ± 9.8 mmol/mol) and decreased to 7.4 ± 0.8% (57 ± 8.7 mmol/mol) at 12 months (P < 0.0001). Subjects who started RT-CGM because of insufficient glycemic control showed stronger decrease in HbA1c at 4, 8, and 12 months compared with patients who started because of hypoglycemia or pregnancy. In the year preceding reimbursement, 16% of patients were hospitalized for severe hypoglycemia or ketoacidosis in contrast to 4% (P < 0.0005) the following year, with decrease in admission days from 54 to 18 per 100 patient years (P < 0.0005). In the same period, work absenteeism decreased and QOL improved significantly, with strong decline in fear of hypoglycemia.Conclusion: Sensor-augmented pump therapy in patients with T1D followed in specialized centers improves HbA1c, fear of hypoglycemia, and QOL, whereas work absenteeism and admissions for acute diabetes complications decreased.
AB - Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use.Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism, and quality of life (QOL).Design: Prospective, observational, multicenter, cohort study.Participants: A total of 515 adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program.Intervention: Initiation of RT-CGM reimbursement.Main Outcome Measure: Hemoglobin A1c (HbA1c) evolution from baseline to 12 months.Results: Between September 1, 2014, and December 31, 2016, 515 adults entered the reimbursement system. Over this period, 417 (81%) patients used RT-CGM for at least 12 months. Baseline HbA1c was 7.7 ± 0.9% (61 ± 9.8 mmol/mol) and decreased to 7.4 ± 0.8% (57 ± 8.7 mmol/mol) at 12 months (P < 0.0001). Subjects who started RT-CGM because of insufficient glycemic control showed stronger decrease in HbA1c at 4, 8, and 12 months compared with patients who started because of hypoglycemia or pregnancy. In the year preceding reimbursement, 16% of patients were hospitalized for severe hypoglycemia or ketoacidosis in contrast to 4% (P < 0.0005) the following year, with decrease in admission days from 54 to 18 per 100 patient years (P < 0.0005). In the same period, work absenteeism decreased and QOL improved significantly, with strong decline in fear of hypoglycemia.Conclusion: Sensor-augmented pump therapy in patients with T1D followed in specialized centers improves HbA1c, fear of hypoglycemia, and QOL, whereas work absenteeism and admissions for acute diabetes complications decreased.
KW - Adult
KW - Blood Glucose Self-Monitoring/methods
KW - Blood Glucose/analysis
KW - Diabetes Mellitus, Type 1/blood
KW - Female
KW - Glycated Hemoglobin A/analysis
KW - Hospitalization/statistics & numerical data
KW - Humans
KW - Hypoglycemia/etiology
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Quality of Life
UR - http://www.scopus.com/inward/record.url?scp=85047749889&partnerID=8YFLogxK
U2 - 10.1210/jc.2017-02498
DO - 10.1210/jc.2017-02498
M3 - Article
C2 - 29342264
VL - 103
SP - 1224
EP - 1232
JO - The Journal of clinical endocrinology and metabolism
JF - The Journal of clinical endocrinology and metabolism
SN - 0021-972X
IS - 3
ER -