Intermittently scanned continuous glucose monitoring compared with blood glucose monitoring is associated with lower HbA 1c and a reduced risk of hospitalisation for diabetes-related complications in adults with type 2 diabetes on insulin therapies.

Autor: Nathanson D; Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Stockholm, Sweden. david.nathanson@regionstockholm.se.; Medical Unit Endocrinology, Karolinska University Hospital Huddinge, Stockholm, Sweden. david.nathanson@regionstockholm.se., Eeg-Olofsson K; Sahlgrenska University Hospital and Department of Molecular & Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.; Centre of Registries Västra Götaland region, Gothenburg, Sweden., Spelman T; Synergus RWE AB, Åkersperga, Sweden., Bülow E; Centre of Registries Västra Götaland region, Gothenburg, Sweden., Kyhlstedt M; Synergus RWE AB, Åkersperga, Sweden., Levrat-Guillen F; Abbott Laboratories Ltd, Maidenhead, UK., Bolinder J; Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Stockholm, Sweden.
Jazyk: angličtina
Zdroj: Diabetologia [Diabetologia] 2025 Jan; Vol. 68 (1), pp. 41-51. Date of Electronic Publication: 2024 Oct 26.
DOI: 10.1007/s00125-024-06289-z
Abstrakt: Aims/hypothesis: We assessed the impact of initiating intermittently scanned continuous glucose monitoring (isCGM) compared with capillary blood glucose monitoring (BGM) on HbA 1c levels and hospitalisations for diabetes-related complications in adults with insulin-treated type 2 diabetes in Sweden.
Methods: This retrospective comparative cohort study included adults with type 2 diabetes who had a National Diabetes Register initiation date for isCGM after 1 June 2017. Prescribed Drug Register records identified subgroups treated with multiple daily insulin injections (T2D-MDI) or basal insulin (T2D-B), with or without other glucose-lowering drugs. The National Patient Register provided data on hospitalisation rates.
Results: We identified 2876 adults in the T2D-MDI group and 2292 in the T2D-B group with an isCGM index date after 1 June 2017, matched with 33,584 and 43,424 BGM control participants, respectively. The baseline-adjusted difference in the change in mean HbA 1c for isCGM users vs BGM control participants in the T2D-MDI cohort was -3.7 mmol/mol (-0.34%) at 6 months, and this was maintained at 24 months. The baseline-adjusted difference in the change in HbA 1c for isCGM users vs BGM control participants in the T2D-B cohort was -3.5 mmol/mol (-0.32%) at 6 months, and this was also maintained at 24 months. Compared with BGM control participants, isCGM users in the T2D-MDI cohort had a significantly lower RR of admission for severe hypoglycaemia (0.51; 95% CI 0.27, 0.95), stroke (0.54; 95% CI 0.39, 0.73), acute non-fatal myocardial infarction (0.75; 95% CI 0.57, 0.99) or hospitalisation for any reason (0.84; 95% CI 0.77, 0.90). isCGM users in the T2D-B cohort had a lower RR of admission for heart failure (0.63; 95% CI 0.46, 0.87) or hospitalisation for any reason (0.76; 95% CI 0.69, 0.84).
Conclusions/interpretation: This study shows that Swedish adults with type 2 diabetes on insulin who are using isCGM have a significantly reduced HbA 1c and fewer hospital admissions for diabetes-related complications compared with BGM control participants.
Competing Interests: Acknowledgements: Editorial assistance in the preparation of this article was provided by R. Brines of Bite Medical Consulting, who collated author drafts and changes, and proofread successive drafts of the manuscript prior to submission. Financial support for this assistance was provided by Abbott Diabetes Care. Parts of this study were presented at the 59th Annual Meeting of the EASD, Hamburg, Germany, 2–6 October 2023. Data availability: Data not presented in the analysis are available on request from the authors. Funding: Open access funding provided by Karolinska Institute. Financial support for this study was provided by Abbott Diabetes Care. Authors’ relationships and activities: DN received honoraria from Abbott for the work within this study. KE-O has received fees for lecturing and/or honoraria for consulting from Sanofi, Novo Nordisk, Eli Lilly and Abbot Diabetes Care. TS has received compensation for serving on scientific advisory boards and honoraria for consultancy from Biogen, as well as speaker honoraria from Novartis. MK is employed by Synergus RWE, which received reimbursement from Abbott to perform the analysis. FL-G is an employee of Abbott Diabetes Care. JB has received honoraria for consulting and/or lecture fees from Abbott Diabetes Care, MannKind Corporation, Nanexa, Nordic InfuCare, Novo Nordisk and Sanofi. Contribution statement: DN, KE-O and JB are the guarantors of this work, and, as such, had full access to all the data in the study, and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed to the methodology, analyses and manuscript writing. All authors gave their approval for this version to be published.
(© 2024. The Author(s).)
Databáze: MEDLINE
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