The Effect of Do-It-Yourself Real-Time Continuous Glucose Monitoring on Glycemic Variables and Participant-Reported Outcomes in Adults With Type 1 Diabetes: A Randomized Crossover Trial.

IF 4.1 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Science and Technology Pub Date : 2025-03-01 Epub Date: 2023-09-06 DOI:10.1177/19322968231196562

Shekhar Sehgal, Mona Elbalshy, Jonathan Williman, Barbara Galland, Hamish Crocket, Rosemary Hall, Ryan Paul, Robert Leikis, Martin de Bock, Benjamin J Wheeler

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引用次数: 0

Abstract

Aim: Real-time continuous glucose monitoring (rtCGM) has several advantages over intermittently scanned continuous glucose monitoring (isCGM) but generally comes at a higher cost. Do-it-yourself rtCGM (DIY-rtCGM) potentially has benefits similar to those of rtCGM. This study compared outcomes in adults with type 1 diabetes using DIY-rtCGM versus isCGM.

Methods: In this crossover trial, adults with type 1 diabetes were randomized to use isCGM or DIY-rtCGM for eight weeks before crossover to use the other device for eight weeks, after a four-week washout period where participants reverted back to isCGM. The primary endpoint was time in range (TIR; 3.9-10 mmol/L). Secondary endpoints included other glycemic control measures, psychosocial outcomes, and sleep quality.

Results: Sixty participants were recruited, and 52 (87%) completed follow-up. Glucose outcomes were similar in the DIY-rtCGM and isCGM groups, including TIR (53.1% vs 51.3%; mean difference -1.7% P = .593), glycosylated hemoglobin (57.0 ± 17.8 vs 61.4 ± 12.2 mmol/L; P = .593), and time in hypoglycemia <3.9 mmol/L (3.9 ± 3.8% vs 3.8 ± 4.0%; P = .947). Hypoglycemia Fear Survey total score (1.17 ± 0.52 vs 0.97 ± 0.54; P = .02) and fear of hypoglycemia score (1.18 ± 0.64 vs 0.97 ± 0.45; P = .02) were significantly higher during DIY-rtCGM versus isCGM. Diabetes Treatment Satisfaction Questionnaire status (DTSQS) score was also higher with DIY-rtCGM versus isCGM (28.7 ± 5.8 vs 26.0 ± 5.8; P = .04), whereas diabetes-related quality of life was slightly lower (DAWN2 Impact of Diabetes score: 3.11 ± 0.4 vs 3.32 ± 0.51; P = .045); sleep quality did not differ between the two groups.

Conclusion: Although the use of DIY-rtCGM did not improve glycemic outcomes compared with isCGM, it positively impacted several patient-reported psychosocial variables. DIY-rtCGM potentially provides an alternative, cost-effective rtCGM option.

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自助式实时连续血糖监测对 1 型糖尿病成人血糖变量和参与者报告结果的影响：随机交叉试验。

目的：实时连续血糖监测（rtCGM）与间歇扫描连续血糖监测（isCGM）相比具有多项优势，但一般成本较高。自己动手做 rtCGM（DIY-rtCGM）可能具有与 rtCGM 相似的优点。这项研究比较了 1 型糖尿病成人患者使用 DIY-rtCGM 和 isCGM 的疗效：在这项交叉试验中，1 型糖尿病成人患者被随机分配使用 isCGM 或 DIY-rtCGM 八周，然后再交叉使用另一种设备八周，经过四周的冲洗期后，参与者恢复使用 isCGM。主要终点是在量程内的时间（TIR；3.9-10 mmol/L）。次要终点包括其他血糖控制指标、社会心理结果和睡眠质量：共招募了 60 名参与者，其中 52 人（87%）完成了随访。DIY-rtCGM 组和 isCGM 组的血糖结果相似，包括 TIR（53.1% vs 51.3%；平均差异-1.7% P = .593）、糖化血红蛋白（57.0 ± 17.8 vs 61.4 ± 12.2 mmol/L；P = .593）和低血糖时间（P = .947）。低血糖恐惧调查总分（1.17 ± 0.52 vs 0.97 ± 0.54；P = .02）和低血糖恐惧得分（1.18 ± 0.64 vs 0.97 ± 0.45；P = .02）在 DIY-rtCGM 期间显著高于 isCGM。糖尿病治疗满意度问卷（DTSQS）得分也是DIY-rtCGM高于isCGM（28.7 ± 5.8 vs 26.0 ± 5.8；P = .04），而糖尿病相关生活质量略低（DAWN2糖尿病影响得分：3.11 ± 0.4 vs 3.32 ± 0.51；P = .045）；睡眠质量在两组之间没有差异：结论：尽管与isCGM相比，DIY-rtCGM的使用并未改善血糖结果，但它对患者报告的几个社会心理变量产生了积极影响。DIY-rtCGM 有可能提供另一种具有成本效益的 rtCGM 选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes Science and Technology Medicine-Internal Medicine

CiteScore

7.50

自引率

12.00%

发文量

148

期刊介绍： The Journal of Diabetes Science and Technology (JDST) is a bi-monthly, peer-reviewed scientific journal published by the Diabetes Technology Society. JDST covers scientific and clinical aspects of diabetes technology including glucose monitoring, insulin and metabolic peptide delivery, the artificial pancreas, digital health, precision medicine, social media, cybersecurity, software for modeling, physiologic monitoring, technology for managing obesity, and diagnostic tests of glycation. The journal also covers the development and use of mobile applications and wireless communication, as well as bioengineered tools such as MEMS, new biomaterials, and nanotechnology to develop new sensors. Articles in JDST cover both basic research and clinical applications of technologies being developed to help people with diabetes.