Real-time CGM Is Superior to Flash Glucose Monitoring for Glucose Control in Type 1 Diabetes: The CORRIDA Randomized Controlled Trial (original) (raw)
Emerging Technologies: Data Systems and Devices| August 28 2020
13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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2Masaryk Hospital, Ústí nad Labem, Czech Republic
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3Department of Paediatrics, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
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4CGParkin Communications, Inc., Henderson, NV
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5Grunberger Diabetes Institute, Bloomfield Hills, MI
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13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
Search for other works by this author on:
13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
Search for other works by this author on:
13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
Search for other works by this author on:
13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
Search for other works by this author on:
13rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
Search for other works by this author on:
Diabetes Care 2020;43(11):2744–2750
Citation
Aneta Hásková, Lucie Radovnická, Lenka Petruželková, Christopher G. Parkin, George Grunberger, Eva Horová, Vendula Navrátilová, Ondřej Kádě, Martin Matoulek, Martin Prázný, Jan Šoupal; Real-time CGM Is Superior to Flash Glucose Monitoring for Glucose Control in Type 1 Diabetes: The CORRIDA Randomized Controlled Trial. _Diabetes Care 1 November 2020; 43 (11): 2744–2750. https://doi.org/10.2337/dc20-0112
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OBJECTIVE
The aim of this trial was to compare the efficacy of real-time and intermittently scanned continuous glucose monitoring (rtCGM and isCGM, respectively) in maintaining optimal glycemic control.
RESEARCH DESIGN AND METHODS
In this randomized study, adults with type 1 diabetes (T1D) and normal hypoglycemia awareness (Gold score <4) used rtCGM (Guardian Connect Mobile) or isCGM (FreeStyle Libre) during 4 days of physical activity (exercise phase) and in the subsequent 4 weeks at home (home phase). Primary end points were time in hypoglycemia (<3.9 mmol/L [<70 mg/dL]) and time in range (3.9–10.0 mmol/L [70–180 mg/dL]). The isCGM group wore an additional masked Enlite sensor (iPro2) for 6 days to check for bias between the different sensors used by the rtCGM and isCGM systems.
RESULTS
Sixty adults with T1D (mean age 38 ± 13 years; A1C 62 ± 12 mmol/mol [7.8 ± 1.1%]) were randomized to rtCGM (n = 30) or isCGM (n = 30). All participants completed the study. Percentage of time in hypoglycemia (<3.9 mmol/L [<70 mg/dL]) was lower among rtCGM versus isCGM participants in the exercise phase (6.8 ± 5.5% vs. 11.4 ± 8.6%, respectively; P = 0.018) and during the home phase (5.3 ± 2.5% vs. 7.3 ± 4.4%, respectively; P = 0.035). Hypoglycemia differences were significant and most notable during the night. rtCGM participants spent more time in range (3.9–10 mmol/L [70–180 mg/dL]) than isCGM participants throughout both the exercise (78.5 ± 10.2% vs. 69.7 ± 16%, respectively; P = 0.0149) and home (75.6 ± 9.7% vs. 67.4 ± 17.8%, respectively; P = 0.0339) phases. The results were robust to the insignificant bias between rtCGM and isCGM sensors that masked CGM found in the isCGM arm.
CONCLUSIONS
rtCGM was superior to isCGM in reducing hypoglycemia and improving time in range in adults with T1D with normal hypoglycemia awareness, demonstrating the value of rtCGM alarms during exercise and in daily diabetes self-management.
© 2020 by the American Diabetes Association
2020
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