Majority of people with type 1 diabetes and multiple daily insulin injection benefit by using Continuous Glucose Monitoring: An analysis based on the GOLD randomised trial (GOLD‐5)

AIMS The aim of this study was to identify responders to continuous glucose monitoring (CGM) in relation to reductions in HbA1c and percentage of time in hypoglycaemia after initiation of CGM for persons with Type 1 Diabetes treated with multiple daily insulin injections. MATERIALS AND METHODS We analysed data from 142 persons from the GOLD randomised clinical trial. We evaluated how many improved HbA1c >0.4% (4.7mmol/mol) or decreased their time in Hypoglycaemia/24hrs >20 and >30 minutes, and which baseline variables were associated with these improvements. RESULTS Lower reduction of HbA1c was associated with greater reduction of hypoglycaemia r=-0.52 (p 0.4% (4.7 mmol/mol) lower HbA1c-values during CGM than with self-measurement of blood-glucose (SMBG) and 47% decreased their time in hypoglycaemia >20 minutes/24 hours. Overall 78% either reduced their HbA1c >0.4% (4.7mmol/mol) or their time in hypoglycaemia >20 minutes/24 hours but only few improved both (14%). Higher HbA1c, lower percentage of time 13.9mmol/l (p=0.016), were associated with greater HbA1c reduction during CGM. Variables associated with greater reduction of time in hypoglycaemia were female sex, greater time with glucose levels <3.0mmol/l, higher CV and higher confidence evaluated by hypoglycaemic confidence questionnaire. CONCLUSION The majority of people with type 1 diabetes managed by MDI benefit from CGM, some experience a reduced HbA1c whilst others reduced time in hypoglycaemia. These factors need to be considered by health professionals, decision-makers for reimbursement and diabetes guidelines. This article is protected by copyright. All rights reserved.