Sensor Technology Aids Those With Non-Insulin-Treated T2D

TOPLINE:

Pilot study finds a non-significant 8 mmol/mol reduction in A1c following the use of intermittent scanning continuous glucose monitoring (isCGM) among adults with type 2 diabetes (T2D) on non-insulin treatment. Use of isCGM was associated with a significant 18% improvement in time in range (TIR).

METHODOLOGY:

A total of 40 adults with T2D were randomly assigned (n = 20 each) to either FreeStyle Libre 2 (Libre 2), an isCGM system, or a “blinded” CGM, the FreeStyle Libre Pro iQ (Libre Pro), for 12 weeks.
Diabetes distress was assessed using the two-item diabetes distress scale.

TAKEAWAY:

Overall, 53% (n = 10/19) of participants in the intervention group achieved the primary outcome, a reduction in A1c of ≥ 5.5 mmol/mol vs 35% (n = 7/20) in the control group (P = .34).
The average TIR rose from 30% at baseline to 50% at follow-up in the isCGM group, a significant 18% increase (P = .028), compared with virtually no change in the blinded CGM group (37%-39%).
Other CGM metrics for hypoglycaemia, hyperglycaemia, and glucose variability were comparable between study groups.
No participants experienced an episode of hypoglycaemia according to CGM data, with zero time spent urea.
The prevalence of high diabetes distress scale decreased from 50% at baseline to 25% at 12 weeks in the intervention groups, whereas increasing from 45% to 55% in the control groups, a non-significant difference between groups (P = .72).
There were no serious adverse events in either group.

IN PRACTICE:

“For adults living with T2DM who are not on insulin, [the National Institute for Health and Care Excellence] does not recommend routine monitoring of blood glucose unless they are on medications that cause hypoglycaemia or have a previous history of hypoglycaemia episodes. However, with the advent of [CGM], many individuals with T2D have started monitoring their glucose levels using these devices,” the authors wrote.

“Improvement in TIR suggests isCGM could potentially have long-term benefits in this population including delaying insulin initiation. Future studies should follow participants for at least 6 months and incorporate food diaries and measurement of activity levels to further characterise the mechanism through which isCGM improves glycaemic outcomes,” they added.

SOURCE:

Conducted by Emmanuel Ssemmondo, MRCP (UK), of Allam Diabetes Centre, University of Hull, and Hull University Teaching Hospitals NHS Trust, Kingston-upon-Hull, UK, and colleagues. The study was published online on December 11, 2024, in Diabetes, Obesity, and Metabolism.