The Effect of Do-It-Yourself Real-Time Continuous Glucose Monitoring on Glycemic Variables and Participant-Reported Outcomes in Adults With Type 1 Diabetes: A Randomized Crossover Trial.

Autor:	Sehgal S; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand., Elbalshy M; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand., Williman J; Department of Paediatrics, Canterbury District Health Board, Christchurch, New Zealand., Galland B; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand., Crocket H; Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand., Hall R; Te Whatu Ora, Capital, Coast and Hutt Valley, Wellington, New Zealand., Paul R; Te Huataki Waiora School of Health, The University of Waikato, Hamilton, New Zealand., Leikis R; Te Whatu Ora, Hawke's Bay, Hastings, New Zealand., de Bock M; Department of Paediatrics, Canterbury District Health Board, Christchurch, New Zealand., Wheeler BJ; Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Jazyk:	angličtina
Zdroj:	Journal of diabetes science and technology [J Diabetes Sci Technol] 2023 Sep 06, pp. 19322968231196562. Date of Electronic Publication: 2023 Sep 06.
DOI:	10.1177/19322968231196562
Abstrakt:	Aim: Real-time continuous glucose monitoring (rtCGM) has several advantages over intermittently scanned continuous glucose monitoring (isCGM) but generally comes at a higher cost. Do-it-yourself rtCGM (DIY-rtCGM) potentially has benefits similar to those of rtCGM. This study compared outcomes in adults with type 1 diabetes using DIY-rtCGM versus isCGM. Methods: In this crossover trial, adults with type 1 diabetes were randomized to use isCGM or DIY-rtCGM for eight weeks before crossover to use the other device for eight weeks, after a four-week washout period where participants reverted back to isCGM. The primary endpoint was time in range (TIR; 3.9-10 mmol/L). Secondary endpoints included other glycemic control measures, psychosocial outcomes, and sleep quality. Results: Sixty participants were recruited, and 52 (87%) completed follow-up. Glucose outcomes were similar in the DIY-rtCGM and isCGM groups, including TIR (53.1% vs 51.3%; mean difference -1.7% P = .593), glycosylated hemoglobin (57.0 ± 17.8 vs 61.4 ± 12.2 mmol/L; P = .593), and time in hypoglycemia <3.9 mmol/L (3.9 ± 3.8% vs 3.8 ± 4.0%; P = .947). Hypoglycemia Fear Survey total score (1.17 ± 0.52 vs 0.97 ± 0.54; P = .02) and fear of hypoglycemia score (1.18 ± 0.64 vs 0.97 ± 0.45; P = .02) were significantly higher during DIY-rtCGM versus isCGM. Diabetes Treatment Satisfaction Questionnaire status (DTSQS) score was also higher with DIY-rtCGM versus isCGM (28.7 ± 5.8 vs 26.0 ± 5.8; P = .04), whereas diabetes-related quality of life was slightly lower (DAWN2 Impact of Diabetes score: 3.11 ± 0.4 vs 3.32 ± 0.51; P = .045); sleep quality did not differ between the two groups. Conclusion: Although the use of DIY-rtCGM did not improve glycemic outcomes compared with isCGM, it positively impacted several patient-reported psychosocial variables. DIY-rtCGM potentially provides an alternative, cost-effective rtCGM option. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: S.S. has no conflicts of interest to disclose. B.J.W. has previously received research funding and expenses from Dexcom, Medtronic, and iSENS. M.B. has received research funding from Novo Nordisk, Medtronic, Dexcom, and Pfizer; research support from Medtronic, Dexcom, and SOOIL; and honoraria from Medtronic. R.P. has received research funding from Dexcom and is a member of New Zealand Advisory Boards for Dexcom, Abbott, Lilly, and Novo Nordisk. H.C. has no relevant disclosures. R.H. is a member of the NZ Advisory Board for Dexcom and has received research funding from NZMS.
Databáze:	MEDLINE
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