Randomized comparison of self-monitored blood glucose (BGM) versus continuous glucose monitoring (CGM) data to optimize glucose control in type 2 diabetes.

Autor: Bergenstal RM; International Diabetes Center, 3800 Park Nicollet Blvd., St. Louis Park, MN 55416, USA. Electronic address: richard.bergenstal@parknicollet.com., Mullen DM; University of Tennessee At Chattanooga, Gary W. Rollins College of Business, 615 McCallie Ave, Fletcher Hall, 323-B, Chattanooga, TN 37403, USA. Electronic address: deborah.mullen@parknicollet.com., Strock E; International Diabetes Center, 3800 Park Nicollet Blvd., St. Louis Park, MN 55416, USA., Johnson ML; International Diabetes Center, 3800 Park Nicollet Blvd., St. Louis Park, MN 55416, USA. Electronic address: mary.johnson@parknicollet.com., Xi MX; International Diabetes Center, 3800 Park Nicollet Blvd., St. Louis Park, MN 55416, USA. Electronic address: Min.X.Xi@HealthPartners.Com.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2022 Mar; Vol. 36 (3), pp. 108106. Date of Electronic Publication: 2021 Dec 31.
DOI: 10.1016/j.jdiacomp.2021.108106
Abstrakt: Aims: Evaluate whether structured BGM testing (BGM) or real-time CGM (CGM) lead to improved glucose control (A1c). Determine which approach optimized glucose control more effectively. METHODS-MULTI-ARM PARALLEL: trial of three type 2 diabetes (T2D) therapies ± metformin: (1) sulfonylurea (SU), (2) incretin (DPP4 inhibitor or GLP-1 agonist), or (3) insulin. After a baseline CGM, 114 adult subjects were randomized to either BGM (4 times daily) or CGM (24/7) for 16 weeks with therapies adjusted every 4 weeks.
Results: A1c means decreased from 8.19 to 7.07 (1.12% difference) with CGM (n = 59) and 7.85 to 7.03 (0.82% difference) with BGM (n = 55) (p < 0.001). BGM and CGM groups showed significant improvements in time in range and glucose variability-with no significant difference between the two groups. Clinically important hypoglycemia (<50 mg/dL) was significantly reduced for the CGM group compared with BGM (p < 0.01), particularly in subjects taking insulin or therapies with higher hypoglycemic risk (SU).
Conclusion: In T2D, structured, consistent use of glucose data regardless of device (structured BGM or CGM) leads to improvements in A1c control. CGM is more effective than BGM in minimizing hypoglycemia particularly for those using higher hypoglycemic risk therapies.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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