Using a continuous glucose monitor (CGM) to assist with diabetes management can have very positive effects on both a person’s physical and mental health.

One CGM, the Dexcom G6, has been shown to have impressive impacts on diabetes management.

In recent years, researchers have been particularly interested in the benefits of real-time CGM (rtCGM, which continuously reports glucose data and alerts users about high or low glucose levels) over intermittently-scanned CGM (isCGM, which reports values only when manually scanned by the user using a separate device).

One study published in JAMA showed that people with type 1 diabetes using the Dexcom G6 experienced significant improvements over those using self-monitoring blood glucose (SMBG), including:

• Their average A1C was reduced by 0.43 percentage points (from 8.35% during the SMBG treatment to 7.92% during CGM treatment)
• Less hypoglycemia, or glucose levels below 70 mg/dL (3.58% during the CGM treatment versus 6.68% during SMBG treatment)
• Improved quality of life
• They were more likely to continue using their treatment compared to those only using SMBG

 A similar study released in 2020 demonstrated that after 6 months of using the Dexcom G6, people with type 1 had:

• A significantly lower A1C than those using SMBG (7.7% versus 7.0%)
• Increased Time in Range by 7.4 percentage points (about 1 hour and 45 minutes each day)
• Reduced Times Above and Below Range

These results were observed regardless of whether participants received multiple daily injections (MDI) of insulin or used an insulin pump. When the group using CGM was switched to SMBG and vice versa, the group now using CGM experienced an identical result to the original group, suggesting that the use of CGM is more important toward maintaining glucose management than the method of insulin delivery.

To better understand the advantages of rtCGM over isCGM, researchers conducted the ALERTT1 trial. In this trial 254 individuals with type 1 diabetes were assigned to either rtCGM or isCGM. Those using rtCGM spent significantly more Time in Range than those who were on isCGM after six months, a difference of 1 hour and 39 minutes per day. In addition, people using rtCGM reported being much happier with their treatment and less worried about hypoglycemia than those on isCGM.

“I believe that alerts and alarms are key in ensuring these improvements in Time in Range,” said Dr. Pieter Gilliard, an investigator on the ALERTT1 trial.  “If someone already has good control of their glucose levels, we would not want to force a change, but it is worth considering a switch from isCGM to rtCGM for those who may struggle with glucose control.” Dr. Gilliard mentioned his vision for a three-year extension to this study, which will investigate the cost-effectiveness and long-term effects of switching to rtCGM.

From www.diaatribe.org

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