Impact of switching from intermittently scanned to real-time continuous glucose monitoring systems in a type 1 diabetes patient French cohort: An observational study of clinical practices.

AIM Assess the impact of switching from intermittently scanned (FreeStyle Libre, FSL) to real-time (Dexcom G4 platinum, DG4) continuous glucose monitoring systems on glycemia control in type 1 diabetes (T1D) patients with high risk of hypoglycemia and/or elevated HbA1c. METHODS We conducted an observational study in 18 T1D adults with poor glycemic control on FSL. Ambulatory Glucose Profile data were collected during the last 3 months of FSL use prior to inclusion (M0 period), during the first 3 months (M3 period) and the last 3 months (M6 period) of DG4 use. Data were then expressed as 24-hr averages. Biological HbA1c was measured for all 3 periods. Patients were their own-controls and statistics were performed using paired t-test or Wilcoxon for matched-pairs. RESULTS The switch to DG4 at M3 resulted in a higher time in range (TIR) 70-180 mg/dL (mean [IQR], 53.1 [44.5; 67.3] vs 41.5 [28.5; 62.0], P = 0.0008), and a lower time below range <70 mg/dL (TBR mean (SD), 5.4 ± 3.7 vs 10.9 ± 7.1, P = 0.0009) and in the glucose % coefficient of variation (%CV mean (SD), 40.1 vs 46.9, P = 0.0001). Mean (SD) changes were +10.3 (8.0) percentage points for TIR, -5.5 (5.8) percentage points for TBR, and -6.8 (5.8) percentage points for %CV. These results were confirmed at the M6 period. CONCLUSIONS Switching from FSL to DG4 appears to provide a beneficial therapeutic option without changing insulin delivery systems, regardless of the origin of the patient's initial glycemic issue.