<b>Objective: </b>International
type 1 diabetes registries have shown that HbA1c levels are highest in young
people with type 1 diabetes, however improving their glycaemic control remains
a challenge. We propose that use of factory-calibrated
Dexcom G6 CGM system would improve glycaemic control in this cohort.
<p><b>Research Design and
Methods: </b>We
conducted a randomized crossover trial in young people with type 1 diabetes (16
– 24 years old), comparing the Dexcom G6 CGM system and self-monitoring of
blood glucose (SMBG). Participants were assigned to the interventions in random
order during two 8-week study periods. During SMBG, blinded CGM was worn by
each participant for 10 days at the start, week-4
and week-7 of the control period. HbA1c measurements were drawn after
enrolment, before and after each treatment period. The primary outcome was time
in range 70–180mg/dl.</p>
<p><b>Results: </b>Time in
range was significantly higher during CGM compared to control [35.7±13.5% vs. 24.6±9.3%,
mean difference 11.1% (95% CI 7.0 to 15.2, p<0.001)]. CGM use reduced mean
sensor glucose [219.7±37.6mg/dl vs. 251.9±36.3mg/dl, mean difference -32.2mg/dl
(95% CI -44.5 to -20.0, p<0.001)] and time above range [61.7±15.1% vs.
73.6±10.4%, mean difference 11.9% (95% CI -16.4 to -7.4, p<0.001)]. HbA1c
level was reduced by 0.76% (95% CI -1.1 to -0.4) [-8.5mmol/mol (95% CI -12.4 to
-4.6, p<0.001)]. Times spent below
range (<70mg/dl and <54mg/dl) were low and comparable during both study periods.
Sensor wear was 84% during the CGM period.</p>
<p><b>Conclusion: </b>CGM use in
young people with type 1 diabetes improves time in target and HbA1c levels
compared to SMBG.<b> </b></p>
Young people with Type 1 diabetes of non-white ethnicity and lower socio-economic status have poorer glycaemic control in England and Wales
