Leinung M, Thompson S, Nardacci E.
Division of Endocrinology, Albany Medical College, Albany, NY.
Objective: To determine the benefits of personal continuous glucose monitoring (CGM) outside of a controlled clinical trial.Methods: CGM use over the past 30 months in our university based clinical practice was reviewed. The charts of all patients using personal CGM after July 2006 were reviewed. Data was collected for one year prior to initiation of CGM and through January 2009. All patient visits were performed by any one of 7 board certified endocrinologists and/or 5 diabetes educators. Severe hypoglycemia was defined as requiring assistance and was determined from patient interviews and chart review.Results: A total of 117 patients initiated CGM between July 06 and Oct 08 and used CGM for at least 2 months (total experience on CGM of 1136 patient-months, average 9.7 months/pt). Average age was 44.5 years (range 14 to 71) and average duration of diabetes 23.9 yrs. All patients were on insulin pumps, including 10 with type 2 DM. Sixty-eight (58%) had pre-existing hypoglycemia unawareness. A1c for one year prior to CGM averaged 7.6%, and with CGM use dropped to 7.2% (p <0.005). A total of 42 patients had severe hypoglycemic events in the year before or during CGM use. Overall, the use of CGM was associated with a significant decrease in the rate of severe hypoglycemia (odds ratio 0.40, 95% CI 0.24 to 0.65).Conclusions: Personal CGM, in a "real world" setting, is able to improve glucose control and reduce the rates of severe hypoglycemia.
PMID: 20061272
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