Impact of the initiation of isCGM soon after type 1 diabetes mellitus diagnosis in adults on glycemic indices and fear of hypoglycemia: a randomized controlled trial

Impact of Early Continuous Glucose Monitoring in Adults with Type 1 Diabetes

Background

Continuous glucose monitoring (CGM) helps manage blood sugar levels and improves quality of life. However, there is limited information on its effects on newly diagnosed type 1 diabetes (T1DM) patients.

Aim

This study aimed to evaluate how starting intermittently scanned CGM (isCGM) within 1-6 months of T1DM diagnosis affects blood sugar control and fear of hypoglycemia in adults.

Methods

Participants wore a blinded sensor for 14 days before being randomly assigned to either the isCGM group (intervention) or the self-monitoring blood glucose (SMBG) group (control). Key outcomes included:

Time below 70 mg/dl (TB70)
Fear of hypoglycemia (FoH), measured by the Hypoglycemia Fear Survey (HFS)
Mean glucose levels
Time in range (TIR)

Results

The study included 23 participants (12 in the intervention group and 11 in the control group), with an average age of 25.6 years. All were on multiple daily insulin injections. Key findings include:

TB70 changed slightly in both groups, with no significant difference.
No change in FoH was observed between the two groups.
Mean glucose levels decreased in the isCGM group but increased in the control group, showing a significant difference.
TIR improved in the isCGM group, but the difference was not significant.

The study concluded early due to changes in CGM reimbursement policies, allowing more patients to access isCGM.

Conclusions

In newly diagnosed T1DM adults, TIR is generally high and the risk of hypoglycemia is low. While using isCGM shortly after diagnosis may lower mean glucose levels, it did not significantly change TB70 or FoH.

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