Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes
Miller KM, Kanapka LG, Rickels M, Ahmann A, Aleppo G, Ang LP, Bhargava A, Bode BW, Carlson AL, Chaytor N, Gannon G, Goland R, Hirsh I, Kiblinger L, Kruger D, Kudva YC, Levy C, McGill J, O'Malley G, Peters A, Philipson L, Philis-Tsimikas A, Pop-Busui R, Salam M, Shah VN, Thompson MJ, Vendrame F, Verdejo A, Weinstock RS, Young L, and Pratley R. Benefit of Continuous Glucose Monitoring (CGM) in Reducing Hypoglycemia is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther 2022.
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.
ePub ahead of print