Increasing digitization with CGM improves glucose control in T1D

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Increasing scanning may reduce fear of hypoglycemia in people with type 1 diabetes using intermittent scanning continuous glucose monitoring (CGM) systems, according to the results of a new study.

An analysis of clinical data and outpatient glycemic profile reports from an outpatient clinic in Poland, study results indicate that increased frequency of scanning with intermittently scanned CGM devices was associated with better glycemic control and reduced fear of hypoglycaemia in people with type 1 diabetes.

“For the first time, we report that higher swiping frequency is associated not only with improved glycemic indices but also with reduced fear of hypoglycemia in adults with type 1 diabetes mellitus using isCGM,” the researchers wrote. “This provides a new argument for advising patients with T1D to undertake frequent examinations while using isCGM.”

As diabetes technology evolves, understanding strategies to maximize the potential of CGM technology has become of utmost importance for improving diabetes management. With this in mind, a team from the University Hospital in Krakow, Poland, set out to assess how the scan frequency of intermittent scanning CGM devices, in particular the FreeStyle Libre 2, might influence glycemic control and fear of blood sugar. hypoglycemia in people with type 1 diabetes.

Using data from electronic medical records of people receiving care from Krakow University Hospital from October to December 2021, investigators identified 77 adult patients with type 1 diabetes with complete information on age, sex, duration of diabetes, type of treatment and presence of diabetic complications for inclusion in the present study. Of this cohort, 39 received multiple daily insulin injections and 38 were insulin pump users. The study cohort had a mean age of 34.1 ± 10.2 years and a mean diabetes duration of 14.7 ± 12.0 years.

For analysis, fear of hypoglycemia was assessed using the Hypoglycemia Fear Survey II (HFS II), which the investigators believe is a validated measure of fear. hypoglycemia in adults with type 1 diabetes and contains both a worry subscale and a separate behavior subscale. . The specific glucose ranges of interest for the current study were defined as time in the range of 70-180 mg/dL (3.9-10.0 mmol/L), time below 70 mg/ dL (10.0 mmol/L).

On analysis, the results indicated that study participants performed an average of 13.8 ± 7.8 swipes per day and significant correlations were observed for swipe frequency and mean blood glucose (r = -0.54, β = -2.1 [95% CI, -2.8 to -1.4]), glycemic management index (r=-0.55, β=-0.05 [95% CI, -0.07 to -0.03]), time in target range (r=0.65, β=1.49 [95% CI, 1.09 to 1.89]), time below 70 mg/dL range (r=-0.25, β=-0.13 [95% CI, -0.25 to -0.02]), time greater than 180 mg/dL (r=-0.58, β=-1.34 [95% CI, -1.77 to -0.91]), and time above 250 mg/dL (r=-0.56, β=-0.75 [95% CI, -1.00 to -0.49]).

When assessing fear of hypoglycemia, initial analysis suggested that the mean total HFS II score was 34.7 ± 16.6, with scores of 16.1 ± 7.2 and 18, 7 ± 12.2 for the behavior and worry subscales. During the analysis, the investigators observed significant correlations between the scanning frequency and the overall HFS II score (r=-0.25, β=-0.53 [95% CI, -1.01 to -0.05]), and with the HFS II behavior subscale (r=-0.24, β=-0.22 [95% CI, -0.43 to -0.02]), but such a significant correlation was observed with the HFS II worry subscale (r=-0.19, β=-0.30 [95% CI, -0.66 to 0.05]).

“For the first time, we found that scan frequency is negatively correlated with FOH in adults with T1D. We showed that increased daily scan rates are associated with reduced fear of scanning. hypoglycemia in people with T1D, as assessed by HFS II scores,” the investigators added.

This article originally appeared on Endocrinology Network.

Reference

1. Hohendorff J, Witek P, Kania M, et al. Higher scan rate correlates with less fear of hypoglycemia in type 1 diabetic patients using isCGM. Endocrinol before (Lausanne). 6 October 2022;13:996933. doi: 10.3389/fendo.2022.996933. eCollection 2022.

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