title: Continuous glucose monitors: use of waveform versus glycemic values in the improvements of glucose control, quality of life, and fear of hypoglycemia.
abstract: How patients are benefitting from continuous glucose monitoring (CGM) remains poorly understood. The focus on numerical glucose values persists, even though access to the glucose waveform and rate of change may contribute more to improved control. This pilot study compared outcomes of patients using CGMs with or without access to the numerical values on their CGM. Ten persons with type 1 diabetes, naïve to CGM use, enrolled in a 12-week study. Subjects were randomly assigned to either unmodified CGM receivers, or to CGM receivers that had their numerical values obscured but otherwise functioned normally. HbA1c, quality of life (QLI-D), and fear of hypoglycemia (HFS) were assessed, at baseline and at week 12. Baseline HbA1c for the entire group was 7.46 ± 1.27%. At week 12 the experimental group HbA1c reduction was 1.5 ± 0.9% (p < .05), the control group's reduction was 0.06 ± 0.61% (p > .05). Repeated measures testing revealed no significant difference in HbA1c reduction between groups. Both groups had reductions in HFS; these reductions were statistically significant within groups (p < .05), but not between groups. QLI-D indices demonstrated improvements (p < .05) in QLI-D total and the health and family subscales, but not between groups. The results of this pilot study suggest that benefits of CGM extend beyond reductions in HbA1c to reductions in fear of hypoglycemia and improvements in quality of life. The display of a numerical glucose value did not improve control when compared to numerically blinded units.
authors.affiliation: Desert Endocrinology, Henderson, NV, USA tomasw@cox.net.
authors.forename: Tomas C
authors.initials: TC
authors.lastname: Walker
authors.affiliation: University of Nevada, School of Nursing, Las Vegas, NV, USA.
authors.forename: Carolyn B
authors.initials: CB
authors.lastname: Yucha
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D004867:Equipment Design; D005239:Fear; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control* / Q000523:psychology; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009505:Nevada; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011788:Quality of Life; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: continuous glucose monitor; diabetes; fear of hypoglycemia; glucose trending; quality of life; waveform