Abstract
In the previous years, several studies have shown that the real-time (RT)-CGM systems are safe and effective in T1D, reducing the time spent in hypoglycemia and hyperglycemia, reducing overall diabetes-related complications and improving both glycemic control and patient quality of life. Even if it may seem intuitive that more glucose data should improve glucose control, it has been difficult to identify a causative relationship, even in pediatric studies, which did not show uniform benefits. The benefits of CGM have been primarily seen in those patients who use their devices for more than 70% of the time (≥ 5 days per week) [1–5].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Effectiveness of continuous glucose monitoring in a clinical care environment: evidence from the Juvenile Diabetes Research Foundation Continuous Glucose Monitoring (JDRF-CGM) trial. Diabetes Care. 2010;33:17–22.
Battelino T, Conget I, Olsen B, et al.; SWITCH Study Group. The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial. Diabetologia. 2012;55:3155–62.
Pickup JC, Freeman SC, Sutton AJ. Glycaemic control in type 1 diabetes during real time continuous glucose monitoring compared with self monitoring of blood glucose: meta-analysis of randomised controlled trials using individual patient data. BMJ. 2011;343:d3805.
Huang ES, O’Grady M, Basu A, et al.; Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. The cost-effectiveness of continuous glucose monitoring in type 1 diabetes. Diabetes Care. 2010;33:1269–74.
Larson NS, Pinsker JE. The role of continuous glucose monitoring in the care of children with type 1 diabetes. Int J Pediatr Endocrinol. 2013;26(1):8.
Roadbard D. Continuous glucose monitoring: a review of recent studies demonstrating improved glycemic outcomes. Diabetes Technol Ther. 2017;19(S3):S25–37.
Danne T, Nimri R, Battelino T, et al. International consensus on use of continuous glucose monitoring. Diabetes Care. 2017;40(12):1631–40. https://doi.org/10.2337/dc17-1600.
DeSalvo DJ, Miller KM, Hermann JM, et al.; T1D Exchange and DPV Registries. Continuous glucose monitoring and glycemic control among youth with type 1 diabetes: International comparison from the T1D Exchange and DPV Initiative. Pediatr Diabetes. 2018;19(7):1271–5.
Wong JC, Foster NC, Maahs DM, et al.; T1D Exchange Clinic Network. Real-time continuous glucose monitoring among participants in the T1D exchange clinic registry. Diabetes Care. 2014;37:2702–9.
Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Tamborlane WV, Beck RW, et al. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008;359:1464–76.
Rewers MJ, Pillay K, de Beaufort C, et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes. ISPAD Clinical Practice Consensus Guidelines 2014 Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Beck RW, Buckingham B, et al. Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes. Diabetes Care. 2009;32:1947–53.
Rewers MJ, Pillay K, de Beaufort C, et al. Assessment and monitoring of glycemic control in children and adolescents with diabetes. ISPAD clinical practice consensus guidelines 2014 compendium. Pediatr Diabetes. 2014;15(Suppl.20):102–14.
Chase HP, Beck RW, Xing D, et al. Continuous glucose monitoring in youth with type 1 diabetes: 12-month follow up of the Juvenile Diabetes Research Foundation continuous glucose monitoring randomized trial. Diabetes Technol Ther. 2010;12:507–15.
O’Connell MA, Donath S, O’Neal DN, et al. Glycaemic impact of patient-led use of sensor-guided pump therapy in type 1 diabetes: a randomised controlled trial. Diabetologia. 2009;52:1250–7.
Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group, Beck RW, Buckingham B, et al. Factors predictive of use and of benefit from continuous glucose monitoring in type 1 diabetes. Diabetes Care. 2009;32:1947–53.
Szypowska A, Ramotowska A, Dzygalo K, Golicki D. Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials. Eur J Endocrinol. 2012;166(4):567–74.
Floyd B, Chandra P, Hall S, Phillips C, Alema-Mensah E, Strayhorn G, Ofili EO, Umpierrez GE. Comparative analysis of the efficacy of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes mellitus. Review. J Diabetes Sci Technol. 2012;6(5):1094–102.
Mauras N, Beck R, Xing D, et al.; Diabetes Research in Children Network (DirecNet) Study Group. A randomized clinical trial to assess the efficacy and safety of real-time continuous glucose monitoring in the management of type 1 diabetes in young children aged 4 to <10 years. Diabetes Care. 2012;35:204–10.
Tansey M, Laffel L, Cheng J, et al.; JDRF CGM Study Group. Satisfaction with continuous glucose monitoring in adults and youths with type 1 diabetes. Diabet Med. 2011;28:1118–22.
Polonsky WH, Hessler D. Perceived accuracy in continuous glucose monitoring: understanding the impact on patients. J Diabetes Sci Technol. 2015;9:339–41.
De Bock M, Cooper M, Retterath A, et al. Continuous glucose monitoring adherence: lessons from a clinical trial to predict outpatient behavior. J Diabetes Sci Technol. 2016;10(3):627–32.
Bergenstal RM, Tamborlane WV, Ahmann A, Buse JB, Dailey G, Davis SN, Joyce C, Perkins BA, Welsh JB, Willi SM, Wood MA, STAR 3 Study Group. Sensor-augmented pump therapy for A1C reduction (STAR 3) study: results from the 6-month continuation phase. Diabetes Care. 2011;34:2403–5.
Temelkova-Kurktschiev TS, Koehler C, Henkel E, et al. Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose or HbA1c level. Diabetes Care. 2000;23:1830–4.
Hirsch IB. Glycemic variability and diabetes complications: does it matter? Of course it does! Diabetes Care. 2015;38:1610–4.
El-Laboudi AH, Godsland IF, Johnston DG, Oliver NS. Measures of glycemic variability in type 1 diabetes and the effect of real-time continuous glucose monitoring. Diabetes Technol Ther. 2016;18:806–12.
Monnier L, Colette C, Wojtusciszyn A, et al. Toward defining the threshold between low and high glucose variability in diabetes. Diabetes Care. 2017;40:832–8.
Foster NC, Miller KM, Tamborlane WV, et al.; T1D Exchange Clinic Network. Continuous glucose monitoring in patients with type 1 diabetes using insulin injections. Diabetes Care. 2016;39:e81–2.
van Beers CA, DeVries JH, Kleijer SJ, et al. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial. Lancet Diabetes Endocrinol. 2016;4:893–902.
Lind M, Polonsky W, Hirsch IB, et al. Design and methods of a randomized trial of continuous glucose monitoring in persons with type 1 diabetes with impaired glycemic control treated with multiple daily insulin injections (GOLD study). J Diabetes Sci Technol. 2016;10:754–61.
Schmidt M. Freestyle Libre Pro receives FDA approval. Diabetes 365 Publisher. October 10, 2016.
Hershey T, Perantie DC, Warren SL, et al. Frequency and timing of severe hypoglycemia affects spatial memory in children with type 1 diabetes. Diabetes Care. 2005;28:2372–7.
Northam EA, Rankins D, Lin A, et al. Central nervous system function in youth with type 1 diabetes 12 years after disease onset. Diabetes Care. 2009;32:445–50.
Beck RW, Hirsch IB, Laffel L, et al. The effect of continuous glucose monitoring in well-controlled type 1 diabetes. Diabetes Care. 2009;32(8):1378–83.
Battelino T, Phillip M, Bratina N, et al. Effect of continuous glucose monitoring on hypoglycemia in type 1 diabetes. Diabetes Care. 2011;34(4):795–800.
Deiss D, Bolinder J, Riveline JP, et al. Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care. 2006;29(12):2730–2.
Ly TT, Hewitt J, Davey RJ, et al. Improving epinephrine responses in hypoglycemia unawareness with real-time continuous glucose monitoring in adolescents with type 1 diabetes. Diabetes Care. 2011;34:50–2.
Hermanides J, Norgaard K, Bruttomesso D, et al. Sensor augmented pump therapy lowers HbA1c in suboptimally controlled type 1 diabetes: a randomized controlled trial. Diabet Med. 2011;28(10):1158–67.
Marzelli MJ, Mazaika PK, Barnea-Goraly N, et al.; Diabetes Research in Children Network (DirecNet). Neuroanatomical correlates of dysglycemia in young children with type 1 diabetes. Diabetes. 2014;63:343–53.
Ly TT, Nicholas JA, Retterath A, et al. Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial. JAMA. 2013;310:1240–7.
Buckingham BA, Raghinaru D, Cameron F, et al. Predictive low-glucose insulin suspension reduces duration of nocturnal hypoglycemia in children without increasing ketosis. Diabetes Care. 2015;38:1197–204.
Calhoun PM, Buckingham BA, Maahs DM, et al. Efficacy of an overnight predictive low-glucose suspend system in relation to hypoglycemia risk factors in youth and adults with type 1 diabetes. J Diabetes Sci Technol. 2016;10:1216–21.
Scaramuzza AE, Arnaldi C, Cherubini V, et al. Use of the predictive low glucose management (PLGM) algorithm in Italian adolescents with type 1 diabetes: CareLink data download in a real-world setting. Acta Diabetol. 2017;54:317–9.
Bergenstal RM, Klonoff DC, Garg SK, et al.; ASPIRE In-Home Study Group. Threshold-based insulin-pump interruption for reduction of hypoglycemia. N Engl J Med. 2013;369(3):224–32.
Battelino T, Nimri R, Dovc K, et al. Prevention of hypoglycemia with predictive low glucose insulin suspension in children with type 1 diabetes: a randomized controlled trial. Diabetes Care. 2017;40(6):764–70.
Tauschmann M, Allen JM, Wilinska ME, et al. Day-and night hybrid closed-loop insulin delivery in adolescents with type 1 diabetes: a free-living, randomized clinical trial. Diabetes Care. 2016;39:1168–74.
Tauschmann M, Allen JM, Wilinska ME, et al. Home use of day-and-night hybrid closed-loop insulin delivery in suboptimally controlled adolescents with type 1 diabetes: a 3-week, free-living, randomized crossover trial. Diabetes Care. 2016;39:2019–25.
Garg SK, Weinzimer SA, Tamborlane WV, et al. Glucose outcomes with the in-home use of a hybrid closed-loop insulin delivery system in adolescents and adults with type 1 diabetes. Diabetes Technol Ther. 2017;19:155–63.
Diabetes Research in Children Network (DirecNet) Study Group. Psychological aspects of continuous glucose monitoring in pediatric type 1 diabetes. Pediatr Diabetes. 2006;7(1):32–8.
Hommel E, Olsen B, Battelino T, et al. Impact of continuous glucose monitoring on quality of life, treatment satisfaction, and use of medical care resources: analyses from the SWITCH study. Acta Diabetol. 2014;51(5):845–51.
Polonsky WH, Hessler D. What are the quality of life-related benefits and losses associated with real-time continuous glucose monitoring? A survey of current users. Diabetes Technol Ther. 2013;15(4):295–301.
Beck RW, Lawrence JM, et al.; Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Quality-of-life measures in children and adults with type 1 diabetes: juvenile diabetes research foundation continuous glucose monitoring randomized trial. Diabetes Care. 2010;33(10):2175–7.
Kovatchev BP, Patek SD, Ortiz EA, Breton MD. Assessing sensor accuracy for non-adjunct use of continuous glucose monitoring. Diabetes Technol Ther. 2015;17:177–86.
Edelman SV. Regulation catches up to reality: nonadjunctive use of continuous glucose monitoring data. J Diabetes Sci Technol. 2017;11:160–4.
Thibault M. Dexcom’s bid for non-adjunctive label blessed by panel. MDDI. N.p., July 22, 2016.
Tilleskjor S. Breaking news: FDA approves the MiniMed 670G system, World’s first hybrid closed loop system. Between The Lines Blog j Medtronic Diabetes. Medtronic. October 15, 2016.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Cherubini, V. (2020). Clinical Studies on Efficacy of Continuous Glucose Monitoring. In: Cherubini, V., Elleri, D., Zucchini, S. (eds) Glucose Sensor Use in Children and Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-030-42806-8_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-42806-8_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-42805-1
Online ISBN: 978-3-030-42806-8
eBook Packages: MedicineMedicine (R0)