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Association of scan frequency with CGM-derived metrics and influential factors in adults with type 1 diabetes mellitus

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Abstract

Introduction

This study aimed to investigate the association between scan frequency and intermittently scanned continuous glucose monitoring (isCGM) metrics and to clarify the factors affecting scan frequency in adults with type 1 diabetes mellitus (T1D).

Methods

We enrolled adults with T1D who used FreeStyle® Libre. Scan and self-monitoring of blood glucose (SMBG) frequency and CGM metrics from the past 90-day glucose data were collected. The receiver operating characteristic curve was plotted to obtain the optimal cutoff values of scan frequency for the target values of time in range (TIR), time above range (TAR), and time below range (TBR).

Results

The study was conducted on 211 adults with T1D (mean age, 50.9 ± 15.2 years; male, 40.8%; diabetes duration, 16.4 ± 11.9 years; duration of CGM use, 2.1 ± 1.0 years; and mean HbA1c, 7.6 ± 0.9%). The average scan frequency was 10.5 ± 3.3 scan/day. Scan frequency was positively correlated with TIR and negatively correlated with TAR, although it was not significantly correlated with TBR. Scan frequency was positively correlated with the hypoglycemia fear survey-behavior score, while it was negatively correlated with some glycemic variability metrics. Adult patients with T1D and good exercise habits had a higher scan frequency than those without exercise habits. The AUC for > 70% of the TIR was 0.653, with an optimal cutoff of 11 scan/day.

Conclusions

In real-world conditions, frequent scans were linked to improved CGM metrics, including increased TIR, reduced TAR, and some glycemic variability metrics. Exercise habits and hypoglycemia fear-related behavior might affect scan frequency. Our findings could help healthcare professionals use isCGM to support adults with T1D.

Clinical Trial Registry No. UMIN000039376.

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Acknowledgements

The authors are grateful to RN Yukiko Tsuchida (Tokyo Women’s Medical University).

Funding

The FGM-Japan study was completed with funding from the Japan Agency for Medical Research and Development (AMED), Japan (Grant number: 18ek0210104h0001, 19ek0210104h0002, 20ek0210104h0003).

Author information

Authors and Affiliations

  1. Division of Preventive Medicine, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan

    Naoki Sakane, Masayuki Domichi, Akiko Suganuma & Seiko Sakane

  2. Division of Diabetes and Endocrinology, The Department of Internal Medicine, Kobe University Graduate School of Medicine Hyogo, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo, 650-0017, Japan

    Yushi Hirota & Akane Yamamoto

  3. Division of Diabetology and Metabolism, Department of Internal Medicine Tokyo Women’s Medical University School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Junnosuke Miura, Hiroko Takaike & Sari Hoshina

  4. Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara-shi, Kanagawa, 259-1143, Japan

    Masao Toyoda & Nobumichi Saito

  5. Division of Diabetes and Lipid Metabolism, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan

    Kiminori Hosoda & Masaki Matsubara

  6. Department of General Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Masaki Matsubara

  7. Department of Internal Medicine, Okayama Saiseikai General Hospital, 2-25 Kokutai-cho, Kita-ku, Okayama-shi, Okayama, 700-8511, Japan

    Atsuhito Tone

  8. Kanda Naika Clinic, 5-21-3 Hannan-cho, Abeno-ku, Osaka-shi, Osaka, 545-0021, Japan

    Satoshi Kawashima

  9. Sawaki Internal Medicine And Diabetes Clinic, 1-1-501A Konyamachi, Takatsuki-shi, Osaka, 569-0804, Japan

    Hideaki Sawaki

  10. Matsuda Diabetes Clinic, 78-7 Ohtsukadai, Nishi-ku, Kobe City, Hyogo, 651-2135, Japan

    Tomokazu Matsuda

  11. Department of Clinical Nutrition, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan

    Takashi Murata

  12. Diabetes Center, National Hospital Organization Kyoto Medical Center, 1-1 Mukaihata-cho, Fukakusa, Fushimi-ku, Kyoto, 612-8555, Japan

    Takashi Murata

Authors
  1. Naoki Sakane
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  2. Yushi Hirota
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  3. Akane Yamamoto
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  4. Junnosuke Miura
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  6. Sari Hoshina
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  7. Masao Toyoda
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  9. Kiminori Hosoda
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  12. Satoshi Kawashima
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  13. Hideaki Sawaki
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  14. Tomokazu Matsuda
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  15. Masayuki Domichi
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  16. Akiko Suganuma
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  17. Seiko Sakane
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  18. Takashi Murata
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Corresponding author

Correspondence to Naoki Sakane.

Ethics declarations

Conflict of interest

YH received lecture fees from Eli Lilly, Sanofi, Abbott, Terumo and Sumitomo Pharma, and research expenses and grants from Sumitomo Pharma. JM received lecture fees from Terumo. MT received lecture fees from Abbott, Terumo and Sumitomo Pharma, Novo Nordisk, and Boehringer Ingelheim and subsides or donations from Cocokara fine Healthcare Inc., LifeScan Japan, Roche DC Japan, and SUPER LIGHT WATER CO., LTD. AT receives lecture fees from Eli Lilly, Sanofi, Abbott, and Terumo.TM received lecture fees from Eli Lilly. Other members declare no competing interests.

Ethical Approval

This study conformed to the standards of the Declaration of Helsinki. The present study was approved by the Ethics Committee of the National Hospital Organization Kyoto Medical Center (No.19–072, approval date: January 20, 2020).

Informed consent

Informed consent or substitute for it was obtained from all patients for being included in the study. Approval date of Registry and the Registration No. of the study/trial: Trial registration number: University hospital Medical Information Network (UMIN) Center: UMIN000039376).

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Sakane, N., Hirota, Y., Yamamoto, A. et al. Association of scan frequency with CGM-derived metrics and influential factors in adults with type 1 diabetes mellitus. Diabetol Int 15, 109–116 (2024). https://doi.org/10.1007/s13340-023-00655-9

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  • DOI: https://doi.org/10.1007/s13340-023-00655-9

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