Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Mosch, C.
A retrospective analysis of diabetes management in people with type 1 diabetes switching from a CGM system without alerts to a system with alerts
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2022. pp. 39
[OPEN ACCESS]
FullText
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Elsayed Hesham
- Mader Julia
- Altmetrics:
- Abstract:
- Introduction Continuous glucose monitoring (CGM) has become an important part of diabetes therapy over the last years and its benefits for people with diabetes have been proven on a large scale. Over the years, alarms for hypo- and hyperglycaemic events have been integrated into many CGM systems. This study was carried out to see if users of an intermittently-scanned CGM (isCGM) system without alerts would benefit from switching to an isCGM system with alerts. Materials and Methods This retrospective, single-centre study included 18 users (72% male, 28% female, mean age 38.8 years ± 12.5 years, mean HbA1c 58.39 mmol/mol ± 12.4 mmol/mol, mean duration of diabetes 18.5 years ± 12.94 year) of an isCGM without alerts (Abbott Libre 1, Abbott Diabetes Care), who were switched during routine care to an isCGM with alerts (Abbott Libre 2, Abbott Diabetes Care). The data 90 days prior to the switch and 90 days after the switch was analysed and included CGM metrics as time in range (TIR), average glucose levels, HbA1c, glucose monitoring indicator (GMI) etc. Results TIR was 56.6% (46.85%-73.53%) for isCGM without alerts and 58.7% (47.14%-72.44%) for isCGM with alerts. TBR <70 mg/dl was 4.76% (1.93%-6.17%) without alerts vs. 3.63% (2.09%-7.21%) with alerts. For the CGM system without alerts time above range (TAR) >180 mg/dl was 39.2% (21.86%-50.91%) and for TAR >250 mg/dl 11.11% (3.49%-19.08%), respectively. With the CGM system with alerts, the TAR >180 mg/dl was 35.65% (22.41%-42.23%) and for TAR >250 mg/dl 9.15% (3.68%-17.83%). Average glucose levels were 167.49 mg/dl (140.28 mg/dl-186.96 mg/dl) without alerts and 161.44 mg/dl (141.02 mg/dl – 186.97 mg/dl) with alerts. The GMI was 56.45 mmol/mol (41.93 mmol/mol – 61.3 mmol/mol) for CGM systems without alarms and 54.87 mmol/mol (43.72 mmol/mol – 61.54 mmol/mol) with alarms. Basal insulin doses could be obtained for all 18 people with diabetes before the switch and for 8 people with diabetes after the switch. Mean total daily insulin dose was 25.0 IU daily (20.0 IU – 30.0 IU) while using the isCGM without alerts and 24.0 IU (19.0 IU – 30.3 IU) while using the isCGM system with alerts. Conclusion Switching to an isCGM with alerts resulted in a slight improvement in TIR, TBR and TAR, but overall, the change in GMI was not significant. Like other CGM trials, glycaemic targets were not achieved for the majority of the users. Further studies and research are needed to enable further improvement in blood glucose control for people with diabetes.