Characteristics of Continuous Glucose Monitoring Metrics in Persons with Type 1 and Type 2 Diabetes Treated with Multiple Daily Insulin Injections

Abstract

Although guidelines advocate similar CGM targets for insulin-treated persons with type 1 and type 2 diabetes, it is unclear how these persons differ with respect to hypoglycaemia, glucose variability and other CGM metrics in clinical practice. Methods; We used data from two multicenter randomized controlled trials (GOLD and MDI-Liraglutide) where 161 persons with type 1 diabetes and 124 persons with type 2 diabetes treated with multiple daily injections were included and monitored with masked CGM. Persons from both cohorts had similar mean glucose levels, 10.9 mmol/l (196 mg/dL) in persons with type 1 diabetes and 10.8 mmol/l (194 mg/dL) in persons with type 2 diabetes. Time in hypoglycemia (<3.9 mmol/l (70 mg/dL) was 5.1% and 1.0 % for persons with type 1 and type 2 diabetes, respectively (p<0.001). Corresponding estimates for the standard deviations of mean glucose levels were 4.4 mmol/l (79 mg/dL) vs 3.0 (54 mg/dL) (p<0.001), for CV 41% vs 28% (p<0.001) and for time in range 38.2% vs 45.3%, respectively (p=0.004). Mean C-peptide levels were 0.05 nmol/l and 0.67 nmol/l (p<0.001) for persons with type 1 and type 2 diabetes, respectively. Persons with type 1 diabetes compared to persons with type 2 diabetes treated with multiple daily injections spend considerably more time in hypoglycemia, have higher glucose variability, and less "Time in range". This needs to be taken into account in daily clinical care and in recommended targets for CGM metrics.