title: Use of continuous glucose monitoring in subjects with type 1 diabetes on multiple daily injections versus continuous subcutaneous insulin infusion therapy: a prospective 6-month study.
abstract: OBJECTIVE
  To compare use of continuous glucose monitoring in subjects with type 1 diabetes on multiple daily injection (MDI) therapy versus continuous subcutaneous insulin infusion (CSII) therapy for 6 months.
  
  
  METHODS
  Sixty type 1 diabetic adults with similar baseline characteristics, using either MDI (n = 30) or CSII (n = 30) therapy, were enrolled in this 6-month prospective study. Subjects were instructed to wear the DexCom SevenPLUS continuous glucose monitor at all times throughout the study. All subjects were initially blinded from the continuous glucose monitoring (CGM) glucose data. After 4 weeks of blinded CGM use, the CGM was unblinded, making glucose data available to the patient. The CGM remained in the unblinded state for the remainder of the study (20 weeks). Clinic visits occurred every 4 weeks, at which time A1C values were collected and CGM data were downloaded.
  
  
  RESULTS
  Mean baseline (± SD) A1C was 7.61 (± 0.76) and 7.63 (± 0.68) for CSII and MDI, respectively (P > 0.05). Without any significant therapy change, A1C decrease at 12 weeks was similar in both groups (P = 0.03). When compared with the blinded phase, unblinded use of CGM was associated with similar but significant reductions in glycemic control and variability parameters. In addition, both therapy groups had similar changes in mean glucose and glucose variability indexes at 3 and 6 months (ITT analysis, P > 0.05). Predefined per protocol analysis (sensor use at least 6 days/week) showed greater improvement in time spent in target range glycemia, 3.9-10.0 mmol/L (70-180 mg/dL), in the CSII group.
  
  
  CONCLUSIONS
  We conclude that CGM provides similar benefits in glucose control for patients using MDI or CSII therapy.
authors.affiliation: Barbara Davis Center for Childhood Diabetes, University of Colorado Denver, School of Medicine, Aurora, Colorado, USA. satish.garg@ucdenver.edu
authors.forename: Satish K
authors.initials: SK
authors.lastname: Garg
authors.forename: Mary K
authors.initials: MK
authors.lastname: Voelmle
authors.forename: Christie R
authors.initials: CR
authors.lastname: Beatson
authors.forename: Hayley A
authors.initials: HA
authors.lastname: Miller
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Crew
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Freson
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Hazenfield
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D055104:Infusions, Subcutaneous / Q000379:methods*; D007279:Injections, Subcutaneous / Q000379:methods*; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose; D007328:Insulin