Tjeckisk studie, publicerad 2016. Patienterna valde regim utifrån behov och i samråd med diabetesteamet.
 
65 typ 1, varav 27 med CGM (SAIR), SAIR= Sensor Augmented Insulin Regim
Prospektiv (ej randomiserad), real-life studie under ett års uppföljning, indelad i 4 grupper:
- Pump (n=20)
- Penna (n=18)
- Pump med CGM (n=15)
- Penna med CGM (n=12)
 
SLUTSATS:
Gruppen med CGM sjönk signifikant bättre än gruppen utan CGM. Även gruppen med enbart pump sjönk, men vid 9 månader signifikant bättre sänkning i CGM (SAIR gruppen)
 
Studien visar att penn-patienterna med CGM hamnar på samma HbA1c nivå som pump-patienterna med CGM. Ingen signifikant skillnad mellan dessa grupperna.
Pumpgruppen sjönk också men efter 9 månader signifikant lägre Hba1c i SAIR grupperna. Med andra ord – CGM har en stor impact på möjligheten att sänka HbA1c.
 
Övrig benefit av CGM sett i studien:
Signifikant lägre GV (glukosvariabilitet) i SAIR grupperna p <0.001 (enbart pump <0.05)
- Minskad frekvens av hypoglykemier i SAIR.  p <0.01 (8 %+/-4% vs 6% +/-3 %)
Ökat antal bolusdoser i SAIR gruppen (6.8 +/-2.2 vs 4.0 +/-0.7) 

Comparison of Different Treatment Modalities for Type 1 Diabetes, Including Sensor-Augmented Insulin Regimens, in 52 Weeks of Follow-Up: A COMISAIR Study. DIABETES TECHNOLOGY & THERAPEUTICS Volume 18, Number 9, 2016

Abstract

Objective: To compare different treatment modalities for patients with type 1 diabetes (T1D) based on real-time continuous glucose monitoring (RT-CGM) or self-monitoring of blood glucose (SMBG) combined with mul-tiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII).

Research Design and Methods: Sixty-five T1D patients were followed up for a year. Of these, 27 started RT-

CGM as part of a sensor-augmented insulin regimen (SAIR); within this SAIR group, 15 subjects started sensor-augmented pump (SAP) therapy and the remaining 12 continued with MDIs (MDIs + RT-CGM). A second group of 20 patients initiated CSII without RT-CGM, while a third group of 18 subjects continued on MDIs and SMBG.

The main endpoints were reduction of HbA1c, glycemic variability (GV), and incidence of hypoglycemia.

Results: After a year, the baseline mean HbA1c in the SAIR group (8.3%) decreased to 7.1% (P<0.0001); both

SAIRsubgroups,SAPandMDIs+RT-CGM,showedcomparableimprovement.TheCSIIgroupalsohadreduced HbA1c (8.4%–0.9% vs. 7.9%–0.7%; P<0.05). Both SAIRs were superior to MDIs (P=0.002) and CSII (P=0.0032). GV was also lowered, both in the SAIR (P<0.0001) and CSII (P<0.05) groups. Reduced incidence of hypoglycemia was observed only with SAIR (8%–4% vs. 6%–3%; P<0.01).

Conclusion: Both SAIRs, SAP and MDIs + RT-CGM, provided significant and comparable decrease of HbA1c with concurrent reduction of hypoglycemia. This improvement was greater than that seen with CSII. The combination of RT-CGM and MDIs can be a suitable alternative to SAP for some patients.

Nyhetsinfo

www red DiabetologNytt