Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes

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Diabetes technology & therapeutics


OBJECTIVE: To evaluate glycemic outcomes in the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) participants during an observational extension phase.

RESEARCH DESIGN AND METHODS: WISDM RCT was a 26-week RCT comparing continuous glucose monitoring (CGM) with blood glucose monitoring (BGM) in 203 adults age ≥60 years with type 1 diabetes. Following the RCT, 100 (98%) CGM group participants continued CGM (CGM-CGM cohort) and 94 (98%) BGM group participants initiated CGM (BGM-CGM cohort) for an additional 26 weeks.

RESULTS: CGM was used a median of >90% of the time at 52 weeks in both cohorts. In the CGM-CGM cohort, median time <70 mg/dL decreased from 5.0% at baseline to 2.6% at 26 weeks and remained stable with a median of 2.8% at 52 weeks (p<0.001 baseline to 52 weeks). Participants spent more time in range 70-180 mg/dL (TIR) (mean 56% versus 64%; p<0.001) and had lower HbA1c (mean 7.6% [59mmol/mol] versus 7.4% [57mmol/mol]; p=0.01) from baseline to 52 weeks. In BGM-CGM, from 26 to 52 weeks median time <70 mg/dL decreased from 3.9% to 1.9% (p<0.001), TIR increased from 56% to 60% (p=0.006) and HbA1c decreased from 7.5%[58mmol/mol] to 7.3%[57mmol/mol] (p=0.025). In BGM-CGM, a severe hypoglycemic event was reported for 9 participants while using BGM during the RCT and for 2 participants during the extension phase with CGM (p=0.02).

CONCLUSIONS: CGM use reduced hypoglycemia without increasing hyperglycemia in older adults with type 1 diabetes. These data provide further evidence for fully integrating CGM into clinical practice.

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ePub ahead of print