Benefits of CGM for Diabetes
Continuous blood glucose monitoring (CGM) has now been available to people with diabetes for more than a decade, but many people with diabetes have no personal experience with this technology. It’s not hard to understand why this is the case – unless you are using an insulin pump, the idea of wearing a device on your body at all times is probably unknown and perhaps off-putting. In fact, it has been estimated that only 6% of people with type 1 diabetes who self-inject insulin wear a continuous glucose monitor – and the rate is probably even lower for type 2 diabetes.
But two new studies show that at least for type 1 diabetes, people who self-inject insulin can consider CGM. Published in the JAMA journal last month, the first study included 158 people with type 1 diabetes who were randomly assigned to their usual care (using a traditional “finger” glucose meter several times a day ), or to wear a continuous blood glucose meter for 24 weeks. At the start of the first study, participants’ average level of HbA1c (a measure of long-term blood sugar control) was 8.6%.
As reported in a MedPage Today article on both studies, after 12 weeks of the first study, CGM group members had reduced their HbA1c by an average of 1.1%, and after 24 weeks, the average decline was 1, 0%. (During the second half of the study period, members of the CGM group were slightly less likely to wear their monitor.) This compared to an average drop of 0.4% in the control group, showing that CGM has makes a significant difference in the results.
Perhaps more importantly, hypoglycemia (hypoglycemia) was less common in the CGM group, with an average of 43 minutes per day versus 80 minutes in the control group.
The second study – which had a similar design and also looked at the effect of CGM on people with type 1 diabetes who inject insulin – showed a slightly less dramatic effect of CGM on blood sugar levels. HbA1c, with a difference of around 0.43% between the two groups after 26 weeks (compared to 0.6% in the first study). But adding to the present positive result, CGM users reported less fear of hypoglycemia and a better level of satisfaction with their treatment than those that continued to receive their regular care.
The authors of the two studies noted that contrary to their expectations – and some previous studies – the participants were generally very good at wearing their glucometer continuously, even if they were not used to wearing medical devices. This indicates that CGM may be suitable for a larger segment of the diabetic population than people who use insulin pumps. It remains to be seen, however, how willing insurance companies will be to pay for treatment in people who inject insulin.
What do you think of these studies – if you self-inject insulin, would you be willing to wear a continuous glucometer? Do you think better blood sugar control and less fear of hypoglycemia are worth wearing a sensor and carrying a CGM or compatible smart device? Should insurance companies pay the CGM for anyone who injects insulin and wants to try the technology? Or should there be strict medical requirements to reduce insurance costs? Leave a comment below!
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