Switching from flash to CGM reduces hypoglycaemia risk

Reddy M, Jugnee N, Anantharaja S, Oliver N (2018) Switching from Flash Glucose Monitoring to Continuous Glucose Monitoring on Hypoglycemia in Adults with Type 1 Diabetes at High Hypoglycemia Risk: The Extension Phase of the I HART CGM Study. Diabetes Technol Ther 20: 751–7 
 

• Recurrent hypoglycaemia can impair awareness of its associated symptoms and lead to severe hypoglycaemia, resulting in increased morbidity and mortality.
• This paper reports on a continuation of the I HART CGM Study, which demonstrated that real-time continuous glucose monitoring (RT-CGM) reduced the risk of hypoglycaemia in high-risk adults with type 1 diabetes compared to flash glucose monitoring.
• In this blinded extension study, 40 participants with impaired hypoglycaemia awareness or a recent episode of severe hypoglycaemia were randomised to flash or RT-CGM for 8 weeks and then given the opportunity to start or continue to use RT-CGM for a further 8 weeks. 
• Thirty-six participants completed the 16-week extension. Investigators compared participants’ glycaemic outcomes at 8 and 16 weeks.
• In the group that switched from flash to RT-CGM, the percentage of time spent in hypoglycaemia dropped significantly from 5% to 0.8% (P=0.0001). Time spent in hypoglycaemia in the group continuing to use RT-CGM was the same at 8 and 16 weeks (1.3% versus1.3%).
• The proportion of time spent within the target glycaemic range (21–63 mmol/mol; 4.1–7.9%) remained the same in the group that continued using RT-CGM but increased in the group switching from flash monitoring.
• Investigators concluded that changing from flash to RT-CGM results in significant improvements in hypoglycaemia outcomes and that the benefit of RT-CGM use is maintained over time in high-risk patients with type 1 diabetes. 

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