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A Randomized Clinical Trial of the Effect of Continuous Glucose Monitoring on Nocturnal Hypoglycemia, Daytime Hypoglycemia, Glycemic Variability, and Hypoglycemia Confidence in Persons with Type 1 Diabetes Treated with Multiple Daily Insulin Injections (GOLD-3)
| Content Provider | Semantic Scholar |
|---|---|
| Author | Ólafsdóttir, Arndís F. Polonsky, William H. Bolinder, Jan Hirsch, Irl B. Dahlqvist, Sofia Wedel, Hans Nyström, Thomas Wijkman, Magnus O. Schwarcz, Erik Hellman, Jarl Heise, Tim Lind, Marcus |
| Copyright Year | 2018 |
| Abstract | BACKGROUND To evaluate the effects of continuous glucose monitoring (CGM) on nocturnal and daytime hypoglycemia in persons with type 1 diabetes treated with multiple daily insulin injections (MDI); we also evaluated factors related to differences in hypoglycemia confidence in this population. METHODS Evaluations were performed from the GOLD randomized trial, an open-label multicenter crossover randomized clinical trial (n = 161) over 69 weeks comparing CGM to self-measurement of blood glucose (SMBG) in persons with type 1 diabetes treated with MDI. Masked CGM and the hypoglycemia confidence questionnaire were used for evaluations. RESULTS Time with nocturnal hypoglycemia, glucose levels <70 mg/dL was reduced by 48% (10.2 vs. 19.6 min each night, P < 0.001) and glucose levels <54 mg/dL by 65%. (3.1 vs. 8.9 min, P < 0.001). For the corresponding glucose cutoffs, daytime hypoglycemia was reduced by 40% (29 vs. 49 min, P < 0.001) and 54% (8 vs. 18 min., P < 0.001), respectively. Compared with SMBG, CGM use improved hypoglycemia-related confidence in social situations (P = 0.016) and confidence in more broadly avoiding serious problems due to hypoglycemia (P = 0.0020). Persons also reported greater confidence in detecting and responding to decreasing blood glucose levels (thereby avoiding hypoglycemia) during CGM use (P = 0.0033) and indicated greater conviction that they could more freely live their lives despite the risk of hypoglycemia (P = 0.022). CONCLUSION CGM reduced time in both nocturnal and daytime hypoglycemia in persons with type 1 diabetes treated with MDI and improved hypoglycemia-related confidence, especially in social situations, thus contributing to greater well-being and quality of life. TRIAL REGISTRATION ClinicalTrials.gov , number NCT02092051. |
| Starting Page | 274 |
| Ending Page | 284 |
| Page Count | 11 |
| File Format | PDF HTM / HTML |
| DOI | 10.1089/dia.2017.0363 |
| Alternate Webpage(s) | https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/56/dia.2017.0363.PMC5910048.pdf |
| Alternate Webpage(s) | http://uu.diva-portal.org/smash/get/diva2:1214645/FULLTEXT01.pdf |
| PubMed reference number | 29608107 |
| Alternate Webpage(s) | https://doi.org/10.1089/dia.2017.0363 |
| Journal | Medline |
| Volume Number | 20 |
| Journal | Diabetes technology & therapeutics |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
