scholarly journals Comment on “The pros and cons of continuous glucose monitoring for patients with type 1 diabetes on multiple daily injections of insulin”. Authors’ reply

Endocrine ◽  
2018 ◽  
Vol 60 (1) ◽  
pp. 197-197
Author(s):  
Michela Petrizzo ◽  
Maria Ida Maiorino ◽  
Katherine Esposito
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Multiple Daily Injections ◽  
Pros And Cons

Continuous glucose monitoring for patients with type 1 diabetes on multiple daily injections of insulin: pros and cons

Endocrine ◽  
2017 ◽  
Vol 59 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Maria Ida Maiorino ◽  
Michela Petrizzo ◽  
Giuseppe Bellastella ◽  
Katherine Esposito
Keyword(s):  
Type 1 Diabetes ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Multiple Daily Injections ◽  
Pros And Cons

scholarly journals Therapy adjustments in people with type 1 diabetes with impaired hypoglycemia awareness on multiple daily injections using real-time continuous glucose monitoring: a mechanistic analysis of the HypoDE study

2021 ◽  
Vol 9 (1) ◽  
pp. e001848
Author(s):  
Delia Waldenmaier ◽  
Guido Freckmann ◽  
Stefan Pleus ◽  
Norbert Hermanns ◽  
Dominic Ehrmann ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Real Time ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Multiple Daily Injections ◽  
Mechanistic Analysis ◽  
Multicenter Randomized Controlled Trial ◽  
Low Glucose

IntroductionStudies have shown beneficial effects of real-time continuous glucose monitoring (rtCGM) usage on clinical outcomes. The objective of this analysis was to identify which therapy adjustments were made by people with type 1 diabetes with impaired hypoglycemia awareness during rtCGM usage enabling reductions in the number of low glucose events observed in the HypoDE (Hypoglycemia in Deutschland) study.Research design and methodsIn the multicenter randomized controlled trial in people with type 1 diabetes on multiple daily injections with impaired hypoglycemia awareness, participants recorded their diabetes therapy in 7-day logbooks at baseline and at 6-month follow-up. They used rtCGM or self-monitoring of blood glucose for therapy adjustments. This mechanistic analysis looked at changes in various aspects of therapy.ResultsLogbooks were completed by 70 participants in the rtCGM group and 65 participants in the control group. Participants in the rtCGM group kept their total carbohydrate consumption, daily insulin doses and distribution constant during the study. However, they reported an increased intake of rescue carbohydrates (0.8±0.6 (mean±SD) vs 1.0±0.8 intake/day; baseline-adjusted between-group difference 0.3 intake (0.1–0.5), p=0.031). The glucose threshold at which rescue carbohydrate intake was initiated was elevated from 71±13 mg/dL (3.9±0.7 mmol/L) to 79±14 mg/dL (4.4±0.8 mmol/L) (adjusted between-group difference +7.6 mg/dL (2.4–12.8) (+0.4 mmol/L (0.1–0.7)); p=0.005) in the rtCGM group. Regression analysis showed that follow-up low glucose events were associated with group allocation (p<0.001), low glucose events at baseline (p=0.016) and rescue threshold (p=0.001).ConclusionsNo major adjustments in insulin therapy were made by study participants with impaired hypoglycemia awareness; however, they were more active in preventing hypoglycemia by taking rescue carbohydrates earlier and more often.Trial registration numberNCT02671968.

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