Short- and Long-Term Effects of Real-Time Continuous Glucose Monitoring in Patients With Type 2 Diabetes
- Robert A. Vigersky, MD1⇓,
- Stephanie J. Fonda, PHD1,
- Mary Chellappa, MD1,
- M. Susan Walker, PHD1 and
- Nicole M. Ehrhardt, MD2
- 1Department of Endocrinology and Metabolism, Diabetes Institute, Walter Reed National Military Medical Center, Bethesda, Maryland
- 2Department of Endocrinology and Metabolism, Walter Reed National Military Medical Center, Fort Belvoir, Virginia
- Corresponding author: Robert A. Vigersky, .
OBJECTIVE To determine whether short-time, real-time continuous glucose monitoring (RT-CGM) has long-term salutary glycemic effects in patients with type 2 diabetes who are not on prandial insulin.
RESEARCH DESIGN AND METHODS This was a randomized controlled trial of 100 adults with type 2 diabetes who were not on prandial insulin. This study compared the effects of 12 weeks of intermittent RT-CGM with self-monitoring of blood glucose (SMBG) on glycemic control over a 40-week follow-up period. Subjects received diabetes care from their regular provider without therapeutic intervention from the study team.
RESULTS There was a significant difference in A1C at the end of the 3-month active intervention that was sustained during the follow-up period. The mean, unadjusted A1C decreased by 1.0, 1.2, 0.8, and 0.8% in the RT-CGM group vs. 0.5, 0.5, 0.5, and 0.2% in the SMBG group at 12, 24, 38, and 52 weeks, respectively (P = 0.04). There was a significantly greater decline in A1C over the course of the study for the RT-CGM group than for the SMBG group, after adjusting for covariates (P < 0.0001). The subjects who used RT-CGM per protocol (≥48 days) improved the most (P < 0.0001). The improvement in the RT-CGM group occurred without a greater intensification of medication compared with those in the SMBG group.
CONCLUSIONS Subjects with type 2 diabetes not on prandial insulin who used RT-CGM intermittently for 12 weeks significantly improved glycemic control at 12 weeks and sustained the improvement without RT-CGM during the 40-week follow-up period, compared with those who used only SMBG.
- Received July 31, 2011.
- Accepted October 7, 2011.
- © 2012 by the American Diabetes Association.
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