https://diabetesjournals.org/care/article-abstract/47/12/2164/157287/Initiation-of-Intermittently-Scanned-Continuous?redirectedFrom=fulltext
Initiation of Intermittently Scanned Continuous Glucose Monitoring Is Associated With Reduced Hospitalization for Acute Diabetes Events and Cardiovascular Complications in Adults With Type 1 Diabetes
We assessed the impact of intermittently scanned continuous glucose monitoring (isCGM) compared with blood glucose monitoring (BGM) on rates of hospitalization for metabolic and vascular complications of diabetes and on HbA1c levels for adults with type 1 diabetes.
This retrospective study using data from the Swedish National Diabetes Register and the Swedish National Patient Register comprised adults with type 1 diabetes and an isCGM initiation date after 1 June 2017 and matched control individuals using BGM. Hospital admission rates were calculated per 100 person-years of follow-up.
We identified 11,822 adults with type 1 diabetes and an isCGM index date after 1 June 2017 and HbA1cbaseline values 3–8 months prior to the index date.
Compared with 3,007 BGM users, isCGM users had
• a significantly lower relative risk of hospitalization for hypoglycemia (0.32; 95% CI 0.14, 0.74),
• diabetic ketoacidosis (0.55; 0.35, 0.87),
• stroke (0.48; 0.37, 0.64),
• acute myocardial infarction (0.64; 0.46, 0.91),
• atrial fibrillation (0.59; 0.38, 0.94),
• heart failure (0.25; 0.16, 0.39),
• peripheral vascular disease (0.21; 0.07, 0.62),
• kidney disease (0.48; 0.35, 0.66), or
• hospitalization for any reason (0.32; 0.29, 0.35).
• Compared with BGM users, change in mean HbA1c for isCGM users was −0.30% (−3.3 mmol/mol) at 6 months and −0.24% (−2.6 mmol/mol) at 24 months (both P < 0.001).
This study shows that adults with type 1 diabetes in Sweden who initiate isCGM have significantly reduced hospitalization rates for acute diabetes events, kidney disease, and cardiovascular complications, along with improved glucose control, compared with BGM users.
ARTICLE HIGHLIGHTS
Why did we undertake this study?
Hospitalization for acute diabetes events is reduced after starting continuous glucose monitoring (CGM) in type 1 diabetes. Less is known aboutthe impact of CGM on chronic metabolic and cardiovascular complications.
What is the specific question we wanted to answer?
Is using intermittently scanned CGM (isCGM) associated with reducedrelative risk of hospitalization for micro- and macrovascular complications oftype 1 diabetes?
What did we find?
Initiating isCGM is associated with a 36–79% reduction in relative risk of hospitalization for cardiovascular complications and kidney diseaseamong adults with type 1 diabetes compared with blood glucose monitoring.
What are the implications of our findings?
These outcomes extend the benefits of using isCGM in type 1 diabetes, including cost-effectiveness in the long-term management of glycemia intype 1 diabetes.
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