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Randomized Controlled Trial
. 2009 Nov;32(11):1947-53.
doi: 10.2337/dc09-0889. Epub 2009 Aug 12.

Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes

Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group  1 ; Roy W Beck, Bruce Buckingham, Kellee Miller, Howard Wolpert, Dongyuan Xing, Jennifer M Block, H Peter Chase, Irl Hirsch, Craig Kollman, Lori Laffel, Jean M Lawrence, Kerry Milaszewski, Katrina J Ruedy, William V Tamborlane
Collaborators, Affiliations
Randomized Controlled Trial

Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes

Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group et al. Diabetes Care. 2009 Nov.

Abstract

Objective: To evaluate factors associated with successful use of continuous glucose monitoring (CGM) among participants with intensively treated type 1 diabetes in the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Randomized Clinical Trial.

Research design and methods: The 232 participants randomly assigned to the CGM group (165 with baseline A1C >or=7.0% and 67 with A1C <7.0%) were asked to use CGM on a daily basis. The associations of baseline factors and early CGM use with CGM use >or=6 days/week in the 6th month and with change in A1C from baseline to 6 months were evaluated in regression models.

Results: The only baseline factors found to be associated with greater CGM use in month 6 were age >or=25 years (P < 0.001) and more frequent self-reported prestudy blood glucose meter measurements per day (P < 0.001). CGM use and the percentage of CGM glucose values between 71 and 180 mg/dl during the 1st month were predictive of CGM use in month 6 (P < 0.001 and P = 0.002, respectively). More frequent CGM use was associated with a greater reduction in A1C from baseline to 6 months (P < 0.001), a finding present in all age-groups.

Conclusions: After 6 months, near-daily CGM use is more frequent in intensively treated adults with type 1 diabetes than in children and adolescents, although in all age-groups near-daily CGM use is associated with a similar reduction in A1C. Frequency of blood glucose meter monitoring and initial CGM use may help predict the likelihood of long-term CGM benefit in intensively treated patients with type 1 diabetes of all ages.

Trial registration: ClinicalTrials.gov NCT00406133.

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Figures

Figure 1
Figure 1
Change in A1C from baseline to 6 months in subjects with baseline A1C ≥7.0% according to average amount of CGM use over the 6-month period. The Ns refer to the number of subjects in each CGM use category. The P values are for the association between sensor use over the 6 months and change in A1C from baseline to 26 weeks, evaluated in a general linear model with sensor use as continuous variable adjusted for baseline A1C.
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