Routine use of continuous glucose monitoring in 10 501 people with diabetes mellitus

Tadej Battelino*, S. Liabat, H. J. Veeze, J. Castañeda, A. Arrieta, O. Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Scopus citations

Abstract

Aims: To analyse blood glucose control according to continuous glucose monitoring use in data from the CareLink database, and to identify factors associated with continuation of sensor use during sensor-augmented pump therapy. Methods: The analysis used data from 10 501 people with Type 1 and 2 diabetes mellitus, of whom 7916 (61.7%) had used glucose sensors for ≥ 15 days during any 6-month period over a 2-year observation period. Data were analysed according to the extent of sensor use ( < 25%, 25-49%, 50-74% and ≥ 75% of the time). Time to discontinuation of sensor use was also analysed in new users of glucose sensors. Results: Compared with patients in the lowest sensor usage group and non-users, the highest glucose sensor usage group had significantly (P < 0.0001) lower mean blood glucose and blood glucose sd, were more likely to achieve a mean blood glucose concentration < 8.6 mmol/l, (odds ratio 1.5, 95% CI 1.3-1.7; P < 0.0001), and had 50% fewer hypoglycaemic (blood glucose concentration < 2.8 mmol/l) episodes. Among new users, sensor use during the first month of therapy was an important predictor of subsequent discontinuation. Lack of full reimbursement was also significantly associated with early discontinuation, whereas measures of glycaemic control were predictive of discontinuation during long-term treatment. Conclusions: The use of continuous glucose monitoring was significantly associated with reductions in hypoglycaemia and improved metabolic control during insulin pump therapy. Sensor use during the first month was strongly associated with long-term adherence; patient education and training may be helpful in achieving this. What's new?: The generalizability to routine clinical use of results obtained on continuous glucose monitoring under the controlled conditions pertaining in clinical trials remains to be established. This study, which involved data from > 10 000 people with diabetes, is the largest study to have analysed objective data derived from a self-uploaded patient electronic database. The analysis showed that the routine home use of continuous glucose monitoring was significantly associated with a reduction in hypoglycaemia and improved metabolic control in people with diabetes receiving insulin pump therapy.

Original languageEnglish
Pages (from-to)1568-1574
Number of pages7
JournalDiabetic Medicine
Volume32
Issue number12
DOIs
StatePublished - 1 Dec 2015
Externally publishedYes

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