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Randomized Controlled Trial
. 2023 Jul;40(7):e15100.
doi: 10.1111/dme.15100. Epub 2023 Apr 18.

Real-time continuous glucose monitoring immediately after severe hypoglycaemia requiring emergency medical services: A randomised controlled trial

Chukwuma Uduku  1 , Valentina Pendolino  2 , Narvada Jugnee  1 , Nick Oliver  1 , Rachael Fothergill  2 , Monika Reddy  1
Affiliations
Randomized Controlled Trial

Real-time continuous glucose monitoring immediately after severe hypoglycaemia requiring emergency medical services: A randomised controlled trial

Chukwuma Uduku et al. Diabet Med. 2023 Jul.

Abstract

Aims: Severe hypoglycaemia requiring emergency medical services remains prevalent despite advances in all aspects of diabetes self-management. Real-time continuous glucose monitoring (RTCGM) technologies can reduce the risk of severe hypoglycaemia for adults with type 1 diabetes, but the impact of these devices has not been assessed in the acute phase after an episode of severe hypoglycaemia.

Methods: We recruited and randomised 35 adults with type 1 diabetes in the acute period after an episode of severe hypoglycaemia requiring emergency medical services and randomised participants to RTCGM with alerts and alarms, or usual care with self-monitored blood glucose for 12 weeks with intermittent blinded CGM. The primary outcome was the difference between groups in percentage time spent in hypoglycaemia (≤3.0 mmol/L, 55 mg/dL).

Results: Thirty participants completed the study (median (IQR) age, duration of diabetes, and BMI was 43 (36-56) years, 26 (19-37) years, and 24.9 (21.9-29.0) kg/m2 , respectively). Sufficient CGM data was available for 15 participants in RT-CGM group and 8 in SMBG group for the primary outcome analysis. The RTCGM group had a significantly larger reduction in exposure to glucose below 3.0 mmol/L (RTCGM -0.16 [-1.23 to 0.01] vs. SMBG 1.58 [0.41 to 3.48], p = 0.03) and episodes of nocturnal hypoglycaemia (RT-CGM -0.03 [-0.15 to 0.02] vs. SMBG 0.05 [-0.03 to 0.40], p = 0.02). Episodes of severe hypoglycaemia were significantly lower in the RTCGM group (RTCGM 0.0 vs. SMBG 4.0, p 0.04).

Conclusions: RTCGM implemented acutely after an episode of severe hypoglycaemia is feasible and clinically effective with important implications for hypoglycaemia management pathways and self-monitoring cost effectiveness.

Keywords: continuous blood glucose monitoring; hypoglycaemia; type 1 diabetes.

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References

REFERENCES

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