How effective is continuous glucose monitoring in intensively treated type 1 diabetes mellitus?
This Practice Point commentary discusses the findings of a multicenter clinical trial conducted by the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. In the study, 322 individuals aged >/=8 years who were already receiving intensive insulin therapy for type 1 diabetes mellitus were randomly assigned to either a group that performed continuous glucose monitoring (CGM), or to a control group that performed conventional self-monitoring with a blood-glucose meter. At week 26, the between-group difference in the change in HbA(1c) level from baseline varied according to the patient's age. A significantly greater reduction in HbA(1c) level in the CGM group compared with the control group was found in patients aged >or=25 years, but not in those aged 8-14 years or 15-24 years. In patients aged >or=25 years, CGM improved glycemic control without increasing the frequency of hypoglycemia. Motivation, willingness to change diabetes self-care behaviors, and the ability to use CGM effectively are important determinants of whether this technology will improve glycemic control.
Wolfsdorf
Joseph I
JI
Division of Endocrinology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. joseph.wolfsdorf@childrens.harvard.edu