Diabetes Health Talk

New research shows that adults with type 1 diabetes who use continuous glucose monitoring devices to help manage their disease control their blood sugar better.

The initial results of the multicenter clinical trial paid for by the Juvenile Diabetes Research Foundation were presented Monday during the European Association for the Study of Diabetes’ annual meeting in Rome. Portions of the study will be published in October in The New England Journal of Medicine, but it is posted online at the journal’s site.

The trial involved 322 patients with type 1 diabetes, ages 8 to 72, at 10 sites, which were coordinated by the Jaeb Center for Health Research in Tampa.

Some patients were assigned to a small continuous glucose monitoring device, which can be attached to the body using a tiny catheter that measures blood glucose levels and produces readings every few minutes. Others were assigned to a control group using standard blood sugar monitoring, which involves manually pricking a finger for blood and testing glucose levels using a separate meter. Researchers tracked the patients for 26 weeks and monitored their A1c levels, an average of a person’s blood sugar levels over the past several months.

An A1c goal for an adult with diabetes is below 7%, and the aim for children is below 7.5%-8%. During the research, patients were analyzed by three age groups: 8 to 14 years, 15 to 24 years, and 25 years or older.

Improvements in blood sugar control were best in the continuous glucose monitoring patient group that was 25 and up, whose A1c levels decreased during the study period by an average of 0.53% compared with control patients. In the other age groups, patients using continuous glucose monitoring fared no better than patients using the traditional method of pricking a finger.

Though the study showed little effect of continuous glucose monitoring in children, in adults, the results indicate that it can control blood sugar.

“One important practical implication is that this is the first study to definitively provide good evidence of the benefit of continuous glucose monitoring — the type of evidence needed for insurers to agree to pay for it,” says study author Roy Beck, executive director of the Jaeb Center. He says that although the devices are approved by the Food and Drug Administration, poor reimbursement limited their use.

David Marrero, an endocrinologist at the Indiana University School of Medicine, says the advantage of continuous glucose monitoring is that patients can see trends that result from behavioral choices, such as food choices and when they eat, in a dynamic way.