Equivalent Efficacy of Intensive Self-Monitoring of Blood Glucose to Real-Time Continuous Glucose Monitoring in Adults with Type 2 Diabetes

Abstract

Effectiveness of real time continuous glucose monitoring (RT-CGM) compared with intensive self-monitoring of blood glucose (SMBG) is not clear. To analyze the effectiveness of RT-CGM, retrospective CGM and, intensive SMBG in adults with type 2 diabetes, we conducted a randomized, open-labelled clinical trial. Patients were type 2 diabetes adults admitted to our hospital from August 2016 to August 2017. Patients of age over 85 years, pregnant, admission less than 1 week were excluded. Patients were randomized to SMBG with RT-CGM using the Medtronic MiniMed 620G, SMBG with retrospective CGM using Medtronic iPro2, or SMBG alone. Both CGMs were worn for 6 days. SMBG was done 6 times a day at every pre-meal and 2 hours post-meal. Primary outcome was the change in HbA1c from baseline to 12weeks. As the secondary outcomes, change in mean glucose level from the admission day to discharge day, and frequency of in-hospital hypoglycemia were evaluated. We also evaluated patients’ satisfaction to treatment using Diabetes Treatment Satisfaction Questionnaire (DTSQ). As the result, 111 patients were enrolled and 33 patients were allocated to RT-CGM group, 26 to retrospective CGM group, and 52 to SMBG group. Among these 111 patients, 63 (56.8%) were male, mean age was 65.1 years, diabetes duration was 8.3 years, BMI was 26.3 kg/m^2, and HbA1c was 9.1%. Overall, glycemic control was improved after treatment for both HbA1c and the mean glucose level; HbA1c from 9.1±1.7% to 6.8±1.0%, mean glucose level from 189±56mg/dl to 137±19mg/dl. However, the changes were not significantly different between the groups. As the safety profile, 34 hypoglycemia was seen during hospitalization with no difference in frequency between the groups (P=0.11). There were no differences in patients’ satisfaction to treatment assessed by DTSQ, either. In conclusion, among adults with type 2 diabetes, intensive SMBG may have the equivalent effect to RT-CGM and retrospective CGM. Disclosure Y. Takano: None. Y. Namiki: None. H. Hiiragi: None. T. Yamada: None. H. Sasaki: None. Y. Murohashi: None. H. Takamine: None. K. Inazumi: None. Y. Terauchi: Research Support; Self; MSD K.K.. Speaker's Bureau; Self; MSD K.K.. Advisory Panel; Self; MSD K.K.. Research Support; Self; Ono Pharmaceutical Co., Ltd.. Speaker's Bureau; Self; Ono Pharmaceutical Co., Ltd.. Research Support; Self; Novartis Pharma K.K., Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Boehringer Ingelheim GmbH. Advisory Panel; Self; Boehringer Ingelheim GmbH. Research Support; Self; Mitsubishi Tanabe Pharma Corporation. Speaker's Bureau; Self; Mitsubishi Tanabe Pharma Corporation. Advisory Panel; Self; Mitsubishi Tanabe Pharma Corporation. Research Support; Self; Daiichi Sankyo Company, Limited. Speaker's Bureau; Self; Daiichi Sankyo Company, Limited. Advisory Panel; Self; Daiichi Sankyo Company, Limited. Research Support; Self; Sanwa Kagaku Kenkyusho Co., Ltd.. Speaker's Bureau; Self; Sanwa Kagaku Kenkyusho Co., Ltd.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Novo Nordisk Inc.. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Advisory Panel; Self; Sanofi. Research Support; Self; Sumitomo Dainippon Pharma Co., Ltd.. Speaker's Bureau; Self; Sumitomo Dainippon Pharma Co., Ltd.. Research Support; Self; Shionogi & Co., Ltd.. Speaker's Bureau; Self; Shionogi & Co., Ltd., Bayer Yakuhin, Ltd., Astellas Pharma US, Inc., AstraZeneca. Advisory Panel; Self; AstraZeneca, Teijin Pharma Limited. U.N. Osada: None.