Sustained Impact of Real-Time CGM in Adults With Type 1 Diab
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In recent years, a growing number of people with type 1 diabetes have gained access to real-time continuous glucose monitoring (rtCGM). Long-term benefits of rtCGM are unclear because of a lack of large studies of long duration. We evaluated whether real-world rtCGM use up to 24 months offered benefits, particularly in those living with impaired awareness of hypoglycemia (IAH).

This 24-month, prospective, observational, cohort study followed 441 adults with insulin pumps receiving full reimbursement for rtCGM. Forty-two percent had IAH. The primary end point was evolution of HbA1c, with secondary end points change in acute hypoglycemia complications, diabetes-related work absenteeism, and quality of life scores. Additionally, researchers also evaluated whether people could achieve glycemic consensus targets during follow-up.

-- After 24 months, HbA1c remained significantly lower compared with baseline.

-- Sustained benefits were also observed for the score on the hypoglycemia fear survey and hypoglycemia-related acute complications irrespective of hypoglycemia awareness level.

-- People with IAH had the strongest improvement, especially for severe hypoglycemia (862 events in the year before vs. 119 events per 100 patient-years in the 2nd year).

-- Over 24 months, more people were able to meet hypoglycemia consensus targets at the expense of slightly fewer people achieving hyperglycemia consensus targets.

-- Furthermore, the number of people with HbA1c <7% without severe hypoglycemia events more than doubled (11.0% vs. 25.4%).

Conclusively, use of rtCGM led to sustained improvements in hypoglycemia-related glucose control over 24 months. Lower fear of hypoglycemia, less acute hypoglycemia-related events, and diabetes-related days off from work were observed, particularly in those with IAH.