Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life

Ondertitel:a real-world study

Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT- CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use. Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism, and quality of life (QOL). Design: Prospective, observational, multicenter, cohort study. Participants: A total of 515 adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program. Intervention: Initiation of RT-CGM reimbursement. Main Outcome Measure: Hemoglobin A1c (HbA 1c ) evolution from baseline to 12 months. Results: Between September 1, 2014, and December 31, 2016, 515 adults entered the reimburse- ment system. Over this period, 417 (81%) patients used RT-CGM for at least 12 months. Baseline HbA 1c was 7.7 6 0.9% (61 6 9.8 mmol/mol) and decreased to 7.4 6 0.8% (57 6 8.7 mmol/mol) at 12 months ( P , 0.0001). Subjects who started RT-CGM because of insufficient glycemic control showed stronger decrease in HbA 1c at 4, 8, and 12 months compared with patients who started because of hypoglycemia or pregnancy. In the year preceding reimbursement, 16% of patients were hospitalized for severe hypoglycemia or ketoacidosis in contrast to 4% ( P , 0.0005) the following year, with decrease in admission days from 54 to 18 per 100 patient years ( P , 0.0005). In the same period, work absenteeism decreased and QOL improved significantly, with strong decline in fear of hypoglycemia.

Jaar van publicatie:2018

BOF-keylabel:ja

CSS-citation score:4

Authors from:Government

Toegankelijkheid:Open