Abstract
Background and AimsTo compare the effects of real-time and retrospective flash glucose monitoring (FGM) on daily glycemic control and lifestyle in patients with type 2 diabetes on premix insulin therapy.Methods and ResultsA total of 172 patients using premix insulin, with HbA1c ≥ 7.0% (56 mmol/mol), or the time below the target (TBR) ≥ 4%, or the coefficient of variation (CV) ≥36% during the screening period, were randomly assigned to retrospective FGM (n = 89) or real-time FGM group (n = 83). Another two retrospective or real-time 14-day FGMs were performed respectively, 1 month apart. Both groups received educations and medication adjustment after each FGM. Time in range (3.9~10.0 mmol/l, TIR) increased significantly after 3 months in the real-time FGM group (6.5%) compared with the retrospective FGM group (-1.1%) (p = 0.014). HbA1c decreased in both groups (both p < 0.01). Real-time FGMs increased daily exercise time compared with the retrospective group (p = 0.002).ConclusionsReal-time FGM with visible blood glucose improves daily glycemic control and diabetes self-care behaviors better than retrospective FGM in patients with type 2 diabetes on premix insulin therapy.Clinical Trial Registration https://clinicaltrials.gov/NCT04847219.
Highlights
Effective self-management, such as self-monitoring of blood glucose (SMBG), diet, and physical activity, is foundational to achieving treatment goals for patients with diabetes [1]
The flash glucose monitoring (FGM) system is a new glucose testing device, which displays an estimate of blood glucose every 15 min and can be scanned for a glucose reading at any time with a long sensor lifetime of 14 days and no need for calibration
The main difference of these two modes of FGM is that the FreeStyle Libre ProTM can mask the glucose levels to patients and reduce the behavior change of patients during glucose monitoring; clinicians can identify and correct patterns of hyper- and hypoglycemia in patients with diabetes; FreeStyle LibreTM provides real-time glucose levels to patients and encourages patients for their diet, exercise, or medication change according to glucose levels immediately
Summary
Effective self-management, such as self-monitoring of blood glucose (SMBG), diet, and physical activity, is foundational to achieving treatment goals for patients with diabetes [1]. The main difference of these two modes of FGM is that the FreeStyle Libre ProTM (blinded mode) can mask the glucose levels to patients and reduce the behavior change of patients during glucose monitoring; clinicians can identify and correct patterns of hyper- and hypoglycemia in patients with diabetes; FreeStyle LibreTM (unblinded mode) provides real-time glucose levels to patients and encourages patients for their diet, exercise, or medication change according to glucose levels immediately. Both of these two modes of FGM are wildly used in patients with diabetes in China. To compare the effects of real-time and retrospective flash glucose monitoring (FGM) on daily glycemic control and lifestyle in patients with type 2 diabetes on premix insulin therapy
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