Continuous Glucose Monitoring Proves Effective Against Hypoglycemia

Continuous glucose monitoring (CGM) reduces hypoglycemia in older adults with type 1 diabetes (T1D), according to a new study published in the Journal of the American Medical Association.

Adults with T1D are a growing yet understudied population. The group is prone to hypoglycemia, which can cause an altered mental status and sometimes seizure or loss of consciousness. According to the study, this can prove fatal.

The randomized study was composed of 203 men and women over the age of 60 spread out over 22 clinical centers. Around half of the participants used an insulin pump while the other half used multiple daily injections of insulin. Participants were split into 2 groups. One group was assigned a Dexcom CGM device while the control group used a standard finger-stick method with test strips for blood glucose monitoring, according to the researchers.

Researchers found that while using the CGM device, participants had a reduced amount of time glucose levels were spent in the hypoglycemia range. The levels went down from 73 minutes per day to 39 minutes per day. Additionally, the control group actually saw the amount of time spent in a hypoglycemia range increase from 68 minutes a day to 70 minutes over the 6-month study period.

According to the researchers, 10 participants in the control group had a severe glycemic event while the CGM group had only 1. At the end of the study, 81% of the CGM group was using the device 7 days a week.

"For too long, the older population with diabetes has suffered from not-so-benign neglect from the medical community.” said Laura Young, MD, PhD, Associate Professor of Medicine in the Division of Endocrinology and Metabolism at the University of North Carolina School of Medicine, in the press release. “Despite the high prevalence of diabetes and its complications in this age group, very few studies have addressed the potential utility of new technologies in this population. In part, this may be due to the mistaken belief that older adults can't manage or benefit from advanced technologies. Our study shows quite the opposite. Not only does CGM improve safety in older adults, it actually improves overall glycemic control.”

Notably, researchers found that the benefits of CGM was present in both those using an insulin pump and multiple daily insulin injections. According to the press release, the effectiveness of CGM may deter those using multiple daily injections from making the switch to more advanced methods that automate insulin.

REFERENCE

Continuous glucose monitoring reduces hypoglycemia in older adults with type 1 diabetes [News Release]. Chapel Hill, NC: EurekAlert!; June 16, 2020. Accessed July 7, 2020.