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Randomized Controlled Trial
. 2022 Feb 10:13:832102.
doi: 10.3389/fendo.2022.832102. eCollection 2022.

Real-Time Flash Glucose Monitoring Had Better Effects on Daily Glycemic Control Compared With Retrospective Flash Glucose Monitoring in Patients With Type 2 Diabetes on Premix Insulin Therapy

Reng-Na Yan  1 , Ting-Ting Cai  1 , Lan-Lan Jiang  1 , Ting Jing  1 , Ling Cai  1 , Xiao-Jing Xie  1 , Xiao-Fei Su  1 , Lan Xu  2 , Ke He  3 , Liang Cheng  4 , Cheng Cheng  5 , Bing-Li Liu  1 , Yun Hu  1   2 , Jian-Hua Ma  1
Affiliations
Randomized Controlled Trial

Real-Time Flash Glucose Monitoring Had Better Effects on Daily Glycemic Control Compared With Retrospective Flash Glucose Monitoring in Patients With Type 2 Diabetes on Premix Insulin Therapy

Reng-Na Yan et al. Front Endocrinol (Lausanne). .

Abstract

Background and aims: To compare the effects of real-time and retrospective flash glucose monitoring (FGM) on daily glycemic control and lifestyle in patients with type 2 diabetes on premix insulin therapy.

Methods and results: A total of 172 patients using premix insulin, with HbA1c ≥ 7.0% (56 mmol/mol), or the time below the _target (TBR) ≥ 4%, or the coefficient of variation (CV) ≥36% during the screening period, were randomly assigned to retrospective FGM (n = 89) or real-time FGM group (n = 83). Another two retrospective or real-time 14-day FGMs were performed respectively, 1 month apart. Both groups received educations and medication adjustment after each FGM. Time in range (3.9~10.0 mmol/l, TIR) increased significantly after 3 months in the real-time FGM group (6.5%) compared with the retrospective FGM group (-1.1%) (p = 0.014). HbA1c decreased in both groups (both p < 0.01). Real-time FGMs increased daily exercise time compared with the retrospective group (p = 0.002).

Conclusions: Real-time FGM with visible blood glucose improves daily glycemic control and diabetes self-care behaviors better than retrospective FGM in patients with type 2 diabetes on premix insulin therapy.

Clinical trial registration: https://clinicaltrials.gov/NCT04847219.

Keywords: flash glucose monitoring; premix insulin; real-time glucose monitoring; time in _target range; type 2 diabetes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study design (A) and trial profile (B).
Figure 2
Figure 2
Changes in daily glycemic control during three flash glucose monitorings in professional and unblinded FGM groups. (A) Percentage time in the _target range of 3.9–10.0 mmol/l (TIR) during the first (baseline, blinded FGM in both groups), second (days 31–45), and third (days 76–90) FGM in the blinded FGM group (n = 89) and unblinded FGM group (n = 83), blue bar; time below the _target range (TBR), red bar; time above the _target range (TAR), yellow bar. Data are percentage; #, vs. first FGM, p value <0.05. (B) Hourly mean blood glucose during the first and third FGMs. Blue solid line, first FGM in the unblinded FGM group; red solid line, third FGM in the unblinded FGM group; green dotted line, first FGM in the blinded FGM group; black dotted line, third FGM in the blinded FGM group. *p < 0.05 between two groups.
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