Use of intermittently scanned continuous glucose monitoring in young people with high-risk type 1 diabetes-Extension phase outcomes following a 6-month randomized control trial.

Abstract

To describe the impact of a 12-month intervention using intermittently scanned continuous glucose monitoring (isCGM) on glycaemic control and glucose test frequency in adolescents and young adults with type 1 diabetes (T1D) and high-risk glycaemic control (HbA1c ≥75mmol/mol [≥9.0%]). In total, 64 young people (aged 13-20years, 16.6±2.1years; 48% female; 41% Māori or Pacific ethnicity; mean diabetes duration 7.5±3.8years) with T1D were enrolled in a 6-month, randomized, parallel-group study comparing glycaemic outcomes from the isCGM intervention (n=33) to self monitoring blood glucose (SMBG) controls (n=31). In this 6-month extension phase, both groups received isCGM; HbA1c , glucose time-in-range (TIR), and combined glucose test frequency were assessed at 9 and 12months. At 12months, the mean difference in HbA1c from baseline was -4mmol/mol [-0.4%] (95% confidence interval, CI: -8, 1mmol/mol [-0.8, 0.1%]; p=0.14) in the isCGM intervention group, and -7mmol/mol [-0.7%] (95% CI: -16, 1mmol/mol [-1.5, 0.1%]; p=0.08) in the SMBG control group. No participants achieved ≥70% glucose TIR (3.9-10.0mmol/L). The isCGM intervention group mean rate of daily glucose testing was highest at 9months, 2.4 times baseline rates (p<0.001), then returned to baseline by 12months (incidence rate ratio=1.4; 95% CI: 0.9, 2.1; p=0.091). The use of isCGM in young people with high-risk T1D resulted in transient improvements in HbA1c and glucose monitoring over a 9-month time frame; however, benefits were not sustained to 12months.