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Observational Study
. 2023 Oct 26:2023:6718115.
doi: 10.1155/2023/6718115. eCollection 2023.

Continuous Glucose Monitoring Provides Durable Glycemic Benefit in Adolescents and Young Adults with Type 1 Diabetes: 12-Month Follow-Up Results

Kellee M Miller  1 , Colleen Bauza  2 , Lauren G Kanapka  2 , Mark A Clements  3 , Daniel J DeSalvo  4 , Korey Hood  5 , Laurel H Messer  6 , Jennifer Sherr  7 , Katherine Bergamo  8 , Amy Criego  9 , Emily Freiner  10 , Sarah K Lyons  4 , Roshanak Monzavi  11 , Wayne Moore  3 , Priya Prahalad  5 , Jill H Simmons  12 , Mark Sulik  13 , R Paul Wadwa  6 , Ruth S Weinstock  14 , Steven M Willi  15 , Kristen Williams  16 , Lori M Laffel  10 ; for the CITY Study Group
Affiliations
Observational Study

Continuous Glucose Monitoring Provides Durable Glycemic Benefit in Adolescents and Young Adults with Type 1 Diabetes: 12-Month Follow-Up Results

Kellee M Miller et al. Pediatr Diabetes. .

Abstract

Objective: To further evaluate glycemic outcomes during the observational extension phase of the Continuous Glucose Monitoring (CGM) Intervention for Teens and Young Adults randomized clinical trial (RCT). Subjects and Methods. Following a 26-week RCT comparing CGM with blood glucose monitoring (BGM) in 153 adolescents and young adults aged 14 to <25 years old with suboptimally controlled type 1 diabetes, 70 (89%) participants in the BGM group initiated use of CGM (referred to as BGM-CGM cohort), and 70 (95%) participants in the CGM group continued to use of CGM (CGM-CGM cohort) for an additional 26 weeks.

Results: In the CGM-CGM cohort, mean hemoglobin A1c (HbA1c) decreased from 8.9% ± 0.9% (74 ± 9.8 mmol/mol) at randomization to 8.3% ± 1.3% (67 ± 14.2 mmol/mol) at 52 weeks (p < 0.001); however, significant improvement in time in target range (TIR) 70-180 mg/dL was not observed from prerandomization (38% ± 13%) to 52 weeks (41% ± 18%). Median percent time <70 mg/dL decreased from 3.0% before randomization to 1.1% at 52 weeks (p < 0.001). In the BGM-CGM cohort, mean HbA1c decreased from 8.9% ± 1.2% (74 ± 13.1 mmol/mol) before CGM initiation to 8.5% ± 1.3% (69 ± 14.2 mmol/mol) after 26 weeks of CGM use (p < 0.001) and mean TIR increased from 34% ± 12% to 38% ± 15% (p=0.01). The median percent time <70 mg/dL decreased from 3.3% before CGM initiation to 1.2% after 26 weeks of CGM use (p < 0.001). No participants discontinued CGM use during the extension phase.

Conclusions: This further evaluation of CGM supports the findings of the preceding RCT that use of CGM improves glycemic control and reduces hypoglycemia in adolescents and young adults with type 1 diabetes. This trial is registered with NCT03263494.

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Conflict of interest statement

KMM has nothing to disclose. CB has nothing to disclose. LGK has nothing to disclose. MAC reports personal fees from Glooko, personal fees from Medtronic, and personal fees from Eli Lilly outside the submitted work. DJD reports personal fees including honoraria and consulting fees independent from the study and nonfinancial support from Dexcom including CGM supplies for the study. KH reports grants from Dexcom and personal fees from Lifescan Diabetes Institute outside the submitted work. LM reports grants from Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study; personal fees from NovoNordisk, personal fees from Lilly, personal fees from Sanofi, personal fees from Insulet, personal fees from Convatec, personal fees from Dexcom, personal fees from Medtronic, personal fees from Roche, personal fees from Boehringer Ingelheim, and personal fees from Insulogic outside the submitted work. JS reports grants from Leona M. and Harry B. Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study; grants and personal fees from Medtronic Diabetes, personal fees from Sanofi, grants and personal fees from Insulet, personal fees from Lilly, and personal fees from Bigfoot Biomedical outside the submitted work. KB has nothing to disclose. AC reports grants and other from T1D Exchange during the conduct of the study; grants from Dexcom, grants from Medtronic, grants from Insulet, grants from JDRF, grants from NIH, grants from Abbott, and other from Eli Lilly outside the submitted work. EF has nothing to disclose. SKL has nothing to disclose. RM reports grants from Leona M. and Harry B. Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study. WM has nothing to disclose. PP reports grants from the JAEB Center for Health Research during the conduct of the study. JHS reports grants from Leona M. and Harry B. Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study. MS has nothing to disclose. RPW reports grants from Leona M. and Harry B. Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study; grants, personal fees, and nonfinancial support from Eli Lilly & Co., grants, personal fees, and nonfinancial support from Dexcom, grants from Bigfoot Biomedical, personal fees from Medtronic, grants and nonfinancial support from MannKind Corporation, grants and nonfinancial support from Novo Nordisk, and grants and nonfinancial support from Tandem Diabetes Care outside the submitted work. RSW reports grants from Leona M. and Harry B. Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study; grants from Insulet Corporation, grants from Tolerion Inc., grants from Eli Lilly and Co., grants from Medtronic, grants from Diasome Pharmaceuticals, grants from Boehringer Ingelheim, grants from Oramed Ltd., grants from Mylan GmbH, and personal fees from Insulogic outside the submitted work. SMW discloses personal fees from Medtronic and Boehringer Ingelheim outside the submitted work has nothing to disclose. KW has nothing to disclose. LML reports grants from Helmsley Charitable Trust and nonfinancial support from Dexcom during the conduct of the study; personal fees from NovoNordisk, personal fees from Lilly, personal fees from Sanofi, personal fees from Insulet, personal fees from Convatec, personal fees from Dexcom, personal fees from Medtronic, personal fees from Roche, personal fees from Boehringer Ingelheim, and personal fees from Insulogic outside the submitted work.

Figures

Figure 1
Figure 1
Proportion of participants achieving glycemic targets in each cohort. (a) Time-in-Range more than 70% of 24 hr period and HbA1c below 7.0%. (b) Less than 1% of time in serious hypoglycemia (<54 mg/dL) and less than 4% of time in hypoglycemia (<70 mg/dL). Solid black bar represents Baseline. Solid dark grey bar represents 26-week visit. Solid light grey represents 52-week visit.
See this image and copyright information in PMC

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