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Real-time CGM superior to flash glucose monitoring for glucose control

Type 1 diabetes – October 2020 digest

This independent study shows that real-time CGM results in significantly more time in range compared with intermittently scanned CGM, probably due to the presence of low and high blood glucose alerts.

The CORRIDA (Comparison of CGM in Randomized Study of Real-time and Intermittently Scanned Systems in T1D With Normal Awareness of Hypoglycemia) study was a head-to-head comparison of real-time continuous glucose monitoring (RT-CGM) versus flash glucose monitoring during 4 days of physical activity and during the subsequent 4 weeks at home.

A total of 60 people with type 1 diabetes, all with normal hypoglycaemia awareness and with no prior experience of glucose monitoring technology, were randomised 1:1 to either treatment. Both groups were trained in the use of their assigned technology, and only basic threshold alarms (4.4–10.0 mmol/L) were set for the RT-CGM group.

The percentage of time spent in hypoglycaemia was significantly lower in the RT-CGM group, in both the exercise and home periods. Combining data in the two periods, the time spent with blood glucose below 3.9 mmol/L was 5.4% versus 8.3% in the RT-CGM and flash groups, respectively, while Time In Range was 76.3% versus 67.9% (P<0.05 for both comparisons). The reduction in Time Below Range was particularly marked overnight (5.1% vs 11.0%), and even more so overnight during the exercise phase (7.7% vs 20.1%).

No significant difference in overall participant-reported quality of life (QoL) was observed between the groups or between baseline and follow-up within groups; however, the authors did not use a diabetes-specific evaluation of QoL.

The authors attribute the superiority of RT-CGM to the presence of alarms and note that more advanced alarm functionality could have further improved glycaemic control. The study was funded by the Ministry of Health of the Czech Republic.

Hásková A, Radovnická L, Petruželková L et al (2020) Real-time CGM is superior to flash glucose monitoring for glucose control in type 1 diabetes: the CORRIDA randomized control trial. Diabetes Care 28 Aug [epub ahead of print].

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