Effect of structured individualized education on continuous glucose monitoring use in poorly controlled patients with type 1 diabetes: A randomized controlled trial. (February 2022)

• Record Type: Journal Article
• Authors: Yoo, Jee Hee; Kim, Gyuri; Lee, Hyun Jung; Sim, Kang Hee; Jin, Sang-Man; Kim, Jae Hyeon
• Is Part Of: Diabetes research and clinical practice. Volume 184(2022)
• Publication Date: 2022-02
• Subjects: Continuous glucose monitoring -- Education -- Time in range -- Type 1 diabetes; AGP ambulatory glucose profile -- CGM continuous glucose monitoring -- DTSQ diabetes treatment satisfaction score -- GMI glucose management indicator -- Is-CGM intermittent scanning continuous glucose monitoring -- MDI multiple daily injections -- Rt-CGM real-time continuous glucose monitoring -- TAR time above range -- TBR time below range -- TIR time in range; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2022.109209
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Structured individualized education for adults with type 1 diabetes treated with rt-CGM resulted in better glycemic outcomes than rt-CGM alone. Educated group had 15.3% (3 h 42 min/day) more time in range (70–180 mg/dL) than the control group. Educated group had 16.1% (3 h 54 min/day) less time above range (>250 mg/dL) than the control group. Education of the control group in an extension study improved their CGM hyperglycemic metrics. Abstract: Aim: We aimed to evaluate the efficacy of structured individualized education combined with real-time continuous glucose monitoring (rt-CGM) on glycemic outcomes in adults with type 1 diabetes. Methods: This was a single-center, 3-month, randomized controlled trial of 47 adults with type 1 diabetes with HbA1c ≥ 7.0% (53 mmol/mol). Study participants were assigned randomly (1:1) to a structured education group or control group. The control group received the same education as the intervention group in a 3-month extension study. The primary outcome was the mean difference in time in range (TIR 70–180 mg/dL [3.9–10.0 mmol/L]) between groups. Results: TIR was higher for the education group than the control group (63.4% vs. 44.5%), resulting in a between-group difference of 15.3% (95% CI 7.9 to 22.8, p < 0.001) at week 12. HbA1c decreased 0.5% (5.5 mmol/mol) more in the intervention group than the control group at week 12 (–0.1 to –1.0, p < 0.001). In the extension period, TIR increased significantly (8.9% [2.2 to 15.6], p = 0.01) in educated control group. Conclusions: In adults with type 1 diabetes, rt-CGM use with individualized education resulted in better TIR than rt-CGM alone, highlighting the importance of personalized structured education when using rt-CGM. (ClinicalTrials.gov, number NCT03794934)