Continuous Glucose Monitoring and Glycemic Control in Young Adults with Type 1 Diabetes: Benefit for Even the Simplest Insulin Administration Methods.

Abstract

The impact of continuous glucose monitoring (CGM) on glycemic control in young adults with type 1 diabetes (T1D) is controversial. Data from 888 young adults with T1D were reviewed (ages 18-30 years, 52% female, glycated hemoglobin [HbA1c] 8.1% ± 1.5%). Prescription of CGM was recorded for 54% of young adults; 66% were pump users, 46% on insulin injections and carbohydrate (carb) counting, and 32% on insulin doses without carb counting (P ≤ 0.001). HbA1c was lower in young adults with CGM versus no CGM (7.7% ± 1.3% vs. 8.2% ± 1.7%, P ≤ 0.001). Difference in HbA1c between CGM versus no CGM was greater in young adults noncarb counting (7.9% ± 1.4% vs. 8.9% ± 2.3%, P = 0.002) than carb counting (7.7% ± 1.5% vs. 8.2% ± 1.7%, P = 0.0008), or pump users (7.6 ± 1.2 vs. 7.9 ± 1.1, P = 0.01). Prescription of CGM was higher with increasing complexity of insulin regimens; however, impact of CGM was greatest with simpler insulin administration methods. Further studies are needed to clarify this association.