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Impact of flash glucose monitoring on hypoglycaemia in adults with type 1 diabetes managed with multiple daily injection therapy: a pre-specified subgroup analysis of the IMPACT randomised controlled trial
- Source :
- Diabetologia
- Publication Year :
- 2017
- Publisher :
- Springer Berlin Heidelberg, 2017.
-
Abstract
- Aims/hypothesis Evidence for the effectiveness of interstitial glucose monitoring in individuals with type 1 diabetes using multiple daily injection (MDI) therapy is limited. In this pre-specified subgroup analysis of the Novel Glucose-Sensing Technology and Hypoglycemia in Type 1 Diabetes: a Multicentre, Non-masked, Randomised Controlled Trial’ (IMPACT), we assessed the impact of flash glucose technology on hypoglycaemia compared with capillary glucose monitoring. Methods This multicentre, prospective, non-masked, RCT enrolled adults from 23 European diabetes centres. Individuals were eligible to participate if they had well-controlled type 1 diabetes (diagnosed for ≥5 years), HbA1c ≤ 58 mmol/mol [7.5%], were using MDI therapy and on their current insulin regimen for ≥3 months, reported self-monitoring of blood glucose on a regular basis (equivalent to ≥3 times/day) for ≥2 months and were deemed technically capable of using flash glucose technology. Individuals were excluded if they were diagnosed with hypoglycaemia unawareness, had diabetic ketoacidosis or myocardial infarction in the preceding 6 months, had a known allergy to medical-grade adhesives, used continuous glucose monitoring (CGM) within the previous 4 months or were currently using CGM or sensor-augmented pump therapy, were pregnant or planning pregnancy or were receiving steroid therapy for any disorders. Following 2 weeks of blinded (to participants and investigator) sensor wear by all participants, participants with sensor data for more than 50% of the blinded wear period (or ≥650 individual sensor results) were randomly assigned, in a 1:1 ratio by a central interactive web response system (IWRS) using the biased-coin minimisation method, to flash sensor-based glucose monitoring (intervention group) or self-monitoring of capillary blood glucose (control group). The control group had two further 14 day blinded sensor-wear periods at the 3 and 6 month time points. Participants, investigators and staff were not masked to group allocation. The primary outcome was the change in time in hypoglycaemia (
- Subjects :
- medicine.medical_specialty
Diabetic ketoacidosis
Endocrinology, Diabetes and Metabolism
030209 endocrinology & metabolism
Subgroup analysis
Hypoglycemia
Article
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Diabetes mellitus
Internal medicine
Internal Medicine
medicine
Devices
Glucose test
030212 general & internal medicine
Adverse effect
Type 1 diabetes
medicine.diagnostic_test
business.industry
medicine.disease
Insulin therapy
business
Hypoglycaemia
Clinical diabetes
Subjects
Details
- Language :
- English
- ISSN :
- 14320428 and 0012186X
- Volume :
- 61
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Diabetologia
- Accession number :
- edsair.doi.dedup.....ca9269b880f1b60df3ac72f783c84c1d