Continuous Glucose Monitoring in Adults With Type 1 Diabetes With 35 Years Duration From the DCCT/EDIC Study

Objective: We evaluated blinded continuous glucose monitoring (CGM) profiles in a subset of adults with type 1 diabetes from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study to characterize the frequency of glycemic excursions and contributing factors. Research Design and Methods: CGM-derived metrics were compared for daytime and nighttime periods using blinded CGM for a minimum of 6.5 days (average 11.9 days) and correlated with HbA1c levels, routine use of diabetes devices, and other characteristics in 765 participants. Results: Participants were 58.9±6.5 years of age with diabetes duration 36.8±4.9 years and HbA1c 7.8±1.2%; 58% used insulin pumps and 27% used personal, unblinded CGM. Compared to daytime, nighttime mean sensor glucose was lower, % time in range 70-180 mg/dL (TIR) was similar and hypoglycemia more common. Over the entire recording period, only 9% of the 765 participants achieved >70% TIR and only 28% achieved Conclusions: In adults with long-standing type 1 diabetes, short-term blinded CGM profiles revealed frequent clinically-significant hypoglycemia (