Editorial

What we're learning from continuous glucose monitoring

Dr Rory McCrimmon of the Editorial Board

Diabetic Hypoglycemia May 2009, Volume 2, Issue 1: page 1-2

Last year the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring (JDRF-CGM) Study Group published a report on the utility of CGM in the management of individuals with type 1 diabetes.1 Because hypoglycemia is the major limitation to the achievement of near-normal glucose levels in type 1 diabetes, this study addressed the question of whether CGM in combination with insulin delivered either by pump or a multi-injection regimen would provide significant improvements in glucose control, with a concomitant reduction in the frequency of hypoglycemia. This multi-center trial randomized 322 adults and children with type 1 diabetes, who were already on intensive insulin therapy, into one of two groups – a CGM group, and a control group who would perform home monitoring with a blood glucose meter. Both groups were then followed for 26 weeks. On completion of the study the investigators found that, the use of CGM was associated with a significantly greater reduction in HbA1c in patients aged ≥25 years. Overall, no significant increase in the incidences of severe hypoglycemia or biochemical hypoglycemia (defined as blood glucose ≤70mg/dl or 3.8mmol/l) was observed in this age group. By contrast, no additional benefit from CGM was found in glycemic control at 26 weeks or reduction in frequency of hypoglycemia in the two younger age groups of 15 to 24 years, and 8 to 14 years.