@article{3ab062ea51f14237a8aab8fed3dab73c,
title = "Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use among Older Adults with Type 1 Diabetes",
abstract = "Objective: To evaluate glycemic outcomes in the Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) participants during an observational extension phase. Research Design and Methods: WISDM RCT was a 26-week RCT comparing continuous glucose monitoring (CGM) with blood glucose monitoring (BGM) in 203 adults aged ?60 years with type 1 diabetes. Of the 198 participants who completed the RCT, 100 (98%) CGM group participants continued CGM (CGM-CGM cohort) and 94 (98%) BGM group participants initiated CGM (BGM-CGM cohort) for an additional 26 weeks. Results: CGM was used a median of >90% of the time at 52 weeks in both cohorts. In the CGM-CGM cohort, median time <70 mg/dL decreased from 5.0% at baseline to 2.6% at 26 weeks and remained stable with a median of 2.8% at 52 weeks (P < 0.001 baseline to 52 weeks). Participants spent more time in range 70-180 mg/dL (TIR) (mean 56% vs. 64%; P < 0.001) and had lower hemoglobin A1c (HbA1c) (mean 7.6% [59 mmol/mol] vs. 7.4% [57 mmol/mol]; P = 0.01) from baseline to 52 weeks. In BGM-CGM, from 26 to 52 weeks median time <70 mg/dL decreased from 3.9% to 1.9% (P < 0.001), TIR increased from 56% to 60% (P = 0.006) and HbA1c decreased from 7.5% (58 mmol/mol) to 7.3% (57 mmol/mol) (P = 0.025). In BGM-CGM, a severe hypoglycemic event was reported for nine participants while using BGM during the RCT and for two participants during the extension phase with CGM (P = 0.02). Conclusions: CGM use reduced hypoglycemia without increasing hyperglycemia in older adults with type 1 diabetes. These data provide further evidence for fully integrating CGM into clinical practice. Clinicaltrials.gov",
keywords = "CGM use, Hyperglycemia, Hypoglycemia, Older adults",
author = "Miller, {Kellee M.} and Kanapka, {Lauren G.} and Rickels, {Michael R.} and Ahmann, {Andrew J.} and Grazia Aleppo and Lynn Ang and Anuj Bhargava and Bode, {Bruce W.} and Anders Carlson and Chaytor, {Naomi S.} and Gail Gannon and Robin Goland and Hirsch, {Irl B.} and Lisa Kiblinger and Davida Kruger and Kudva, {Yogish C.} and Levy, {Carol J.} and McGill, {Janet B.} and Grenye O'Malley and Peters, {Anne L.} and Philipson, {Louis H.} and Athena Philis-Tsimikas and Rodica Pop-Busui and Maamoun Salam and Shah, {Viral N.} and Thompson, {Michael J.} and Francesco Vendrame and Alandra Verdejo and Weinstock, {Ruth S.} and Laura Young and Richard Pratley",
note = "Funding Information: A.C. reports grants and other from Novo Nordisk, grants and other from Medtronic, grants and other from Insulet, grants and other from Sanofi, grants from Dexcom, grants and other from Abbott, other from Senseonics, grants and other from Eli Lilly, and grants from UnitedHealth outside the submitted work; in addition, A.C. has a patent to U.S. Provisional Patent Application Serial No. 62/443,004 pending. N.S.C. reports personal fees from Eli Lilly, Inc. G.G. has nothing to disclose. R.G. has nothing to disclose. I.B.H. receives research funding from Medtronic Diabetes, Insulet, and Beta Bionics, and reports consulting from Abbott Diabetes Care and Bigfoot. L.K. reports contract with Lifescan, affiliation with Voluntis. D.K. reports grants and personal fees from Dexcom outside the submitted work. Y.C.K. reports product support from Dexcom and Roche Diabetes and consulting with Novo. Funding Information: A.P. reports personal fees from Medscape, grants from Dexcom and devices for research received from Abbott Diabetes Care, personal fees from Abbot Diabetes Care, personal fees from MannKind, personal fees from Novo-Nordisk, personal fees from Eli Lilly, personal fees from Merck, personal fees from Zealand; and Stock options: Omada Health and Teladoc. L.H.P. has nothing to disclose. A.P.T. reports nonfinancial support from Dexcom. R.P.B. reports grants from Dexcom outside the submitted work. M.S. reports personal fees from Lilly. V.N.S. reports receiving research support through University of Colorado from Eli-Lilly, NovoNordisk, Sanofi, Dexcom, vTv therapeutics, Mylan GmbH, and Insulet. V.N.S. also served on advisory board of Sanofi and Medscape LLC. M.J.T. has nothing to disclose. F.V. reports a grant from Tolerion, Inc. Funding Information: B.W.B. reports grants from the employer from Abbott Diabetes Care, Bio-Provention, DexCom, Diasome, Insulet, Janssen, JAEB Center for Health Research, Eli Lilly, Med-tronic, Novo Nordisk, Sanvita, Senseonics, Sanofi, Viacyte, and Xeris. B.W.B. has received personal fees for consulting and speaking from Astra Zeneca, Big Foot, Companion Medical, Eli Lilly, MannKind, Medronic, Novo Nordisk, Sanofi, Senseonics, Xeris and Zealand. Funding Information: K.M.M. reports nonfinancial support of supplies provided from Dexcom. L.G.K. has nothing to disclose. M.R.R. reports grants from Xeris Pharmaceuticals, personal fees from Semma Therapeutics, and personal fees from Sernova Corporation. A.J.A. reports grants from Dexcom and personal fees from Medtronic. G.A. reports grants from Novo Nordisk, grants from Dexcom, grants from Astra Zeneca, grants from Eli Lilly, grants from Insulet, personal fees from Dexcom, and personal fees from Insulet. LA has nothing to disclose. Funding Information: Study funded by JDRF and the Leona M. and Harry B. Helmsley Charitable Trust; grant provided to Jaeb Center for Health Research and paid to each of the investigator{\textquoteright}s institutions. Public Health Service Research Grant UL1TR001878 supports the Center for Human Phenomic Science at the University of Pennsylvania. Nonfinancial support: Dexcom, Inc., provided study CGM devices and sensors. Funding Information: C.J.L. reports grant support from Abbott Diabetes, and grant support and nonfinancial support from Dexcom outside the submitted work, grant support from Insulet, and personal fess from Eli Lilly, Inc. J.B.M. reports personal fees and nonfinancial support from Bayer, personal fees and nonfinancial support from Boehringer Ingelheim, personal fees from Lilly, personal fees from Mannkind, personal fees from Novo Nordisk, personal fees from Salix, and grants and personal fees from Dexcom, grants from Medtronic, grants from NIH, and grants from Leona Helmsley Trust. G.O.M. reports grant support from Abbott Diabetes, and grant support and nonfinancial support from Dexcom outside the submitted work, and grant support from Insulet. Funding Information: A.V. has nothing to disclose. R.S.W. reports grants from Insulet Corporation, grants from Tolerion, Inc., grants from Eli Lilly and Co, grants from Medtronic, grants from Dia-some Pharmaceuticals, and grants from Boehringer In-gelheim. L.A.Y. reports grants from Dexcom, vTv therapeutics, NovoNordisk, Boehringer Ingelheim, Bayer, Sanofi US, Johnson and Johnson, Eli Lilly and Lexicon. R.P. reports grants from Hanmi Pharmaceutical Co.; grants from Janssen; consulting fees from Merck; grants, speaker fees and consulting fees from Novo Nordisk; consulting fees from Pfizer; grants from Poxel SA; grants and consulting fees from Sanofi; consulting fees from Scohia Pharma, Inc.; consulting fees from Sun Pharmaceutical Industries. Fees and honoraria for Dr. Richard Pratley{\textquoteright}s services were paid for directly to AdventHealth, a nonprofit organization. Publisher Copyright: {\textcopyright} Copyright 2022, Mary Ann Liebert, Inc., publishers 2022.",
year = "2022",
month = jun,
day = "1",
doi = "10.1089/dia.2021.0503",
language = "English (US)",
volume = "24",
pages = "424--434",
journal = "Diabetes Technology and Therapeutics",
issn = "1520-9156",
publisher = "Mary Ann Liebert Inc.",
number = "6",
}