OBJECTIVE
<p>To investigate whether intermittently scanned
continuous glucose monitoring (isCGM) significantly improves glycemic control
compared with capillary self-monitored blood glucose (SMBG) in youth with type
1 diabetes and high-risk glycemic control.</p>
<p>RESEARCH DESIGN AND METHODS</p>
<p>This multi-center 6-month randomized, controlled,
parallel-arm trial included 64 participants aged 13 to 20 years with established
Type 1 diabetes and glycated hemoglobin (HbA1c) ≥9% (≥75mmol/mol). Participants
were allocated to 6-month intervention (isCGM, FreeStyle Libre, Abbott; n = 33)
or control (SMBG; n = 31) using minimization. The primary outcome was the
difference in change in HbA1c from baseline to 6 months. </p>
<p>RESULTS</p>
<p>There was no evidence of a difference between groups
for changes in HbA1c at 6 months (adjusted mean 0.2% greater improvement for
isCGM, 95% CI -0.9% to 0.5% [-2.1 mmol/mol, 95% CI -9.6 to 5.4], p = 0.576).
However, glucose monitoring frequency was 2.83 (95% CI 1.72 to 4.65, p <
0.001) times higher in the isCGM group compared to that in the SMBG group at 6
months. The change in the Diabetes Treatment Satisfaction Questionnaire mean
item score also favored isCGM at 6 months (p=0.048), with no significant
differences between groups for fear of hypoglycemia and quality of life (both
general and diabetes-specific) all p>0.1.</p>
<p>CONCLUSIONS</p>
<p>For youth with high-risk glycemic control, isCGM led
to improvements in glucose testing frequency and diabetes treatment
satisfaction. However, these did not translate to greater improvement in
glycemic control over usual care with SMBG at 6 months. </p>
Type 1 diabetes: treatment without tears?
