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Intermittent scanning continuous glucose monitoring (isCGM) may help reduce hypoglycemic unawareness and the number of hypoglycemic episodes in people with type 1 diabetes (T1D), reports a new study published in the journal Neurology. Diabetes Research and Clinical Practice.1 The authors noted that isCGM may also offer cost savings compared with self-monitoring of glucose levels and real-time CGM (rtCGM).
Intermittent scanning CGM can reduce hypoglycemic episodes in type 1 diabetes patients / Andrey Popov – stock.adobe.com
CGM technology has led to improved diabetes management for many patients, with studies showing that the devices can significantly improve glycemic control, average blood glucose levels, and HbA1c levels.2 One form of this technology is isCGM, which has proven beneficial for a variety of patient populations, including those with pre-diabetes and those who have difficulty with fingersticks.3 Studies have shown that rtCGM reduces hypoglycemic unawareness, but there is a lack of data on whether isCGM also helps in this regard.
Key Takeaways
- One study found that the use of intermittent scanning continuous glucose monitoring (isCGM) reduced hypoglycemia unawareness by 45.8% in patients with type 1 diabetes (T1D) over a two-year follow-up period.
- Patients using isCGM showed significant improvements in glycemic parameters, including reduced blood glucose variability, time in the hypoglycemic range, and the number and duration of hypoglycemic episodes.
- The study also found reduced hypoglycemia-related fears and reduced total insulin doses in patients using isCGM, suggesting an overall improvement in quality of life and diabetes management for these patients.
“Hypoglycemia is a significant barrier to glycemic control in patients with type 1 diabetes,” the authors write. “Impaired awareness of hypoglycemia (IAH) is a highly prevalent symptom in these patients and increases the risk of severe hypoglycemia, resulting in increased mortality, morbidity, and costs…”[However] In previous studies, [hypoglycemia unawareness] “By using isCGM.”
read more: Investigating trends in GLP-1 in type 2 diabetes and the risk of obesity-related malignancies
Researchers from the Diabetes and Metabolism Research Unit at the Vall d'Hebron Institute in Barcelona, Spain, conducted a study to evaluate the impact of real-world use of isCGM on hypoglycemia and its cognitive impairment in patients with type 1 diabetes. The real-world observational prospective pilot study included a 2-year follow-up and used the Clark Questionnaire to assess hypoglycemia unawareness and the Hypoglycemia Fear Survey to evaluate psychological aspects related to hypoglycemia.
The study cohort included 60 patients aged 16 years or older with type 1 diabetes and frequent hypoglycemic attacks who were seen at the hospital between October and December 2021. All patients used the isCGM type Abbott Freestyle Libre 2 continuously for two years and received diabetes education based on a structured program on the use of CGM, methods to prevent and treat hypoglycemic attacks, and dietary information.
The researchers found that after two years of follow-up, patients using isCGM had reduced blood glucose variability, time in the hypoglycemic range, time in the very hypoglycemic range, fewer events related to low blood glucose levels, and shorter duration of hypoglycemic episodes. These improvements were confirmed at one year of follow-up and persisted through two years of follow-up.
Additionally, patients using isCGM experienced a 45.8% reduction in hypoglycemia unawareness from baseline and reduced fear of hypoglycemia. The study also showed that patients reduced their total insulin dose.
Limitations of the study include that the education patients received throughout the study likely influenced the reduction in hypoglycemic unawareness, only patients with utilization rates greater than 70% were included in the study, and there was a lack of specific information regarding physical activity.
“In this real-world study with 2 years of follow-up, we found that the use of a meter with alarm function in patients with type 1 diabetes significantly improved blood glucose measurement parameters, especially those related to blood glucose variability and hypoglycemia,” the authors conclude. “In the latter respect, it should be emphasized that there was a significant reduction in the time of hypoglycemia, the duration of severe hypoglycemic episodes, and the number of nocturnal hypoglycemic episodes.”
read more: Continuous Glucose Monitoring Resource Center
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