Continuous Glucose Monitor Advantages Type 2 Diabetes Mellitus Control, Some New Researches Show

Press release: 01 August, 2021: CGM (continuous glucose monitoring) is a popular treatment option for type 1 diabetics. Now, two new research studies suggest that CGM might be a worthwhile option to add to the treatment plans of patients with type 2 diabetes who use insulin.

Researchers found that insulin-dependent type 2 diabetics may gain more from the device than conventional blood glucose monitors that are placed on their skin every few days to check their blood sugar levels.

Researchers examined the efficacy of two different monitoring devices on 175 people with type 2 diabetes being treated with insulin. Participants' average hemoglobin A1C levels, which indicate average blood sugar levels over approximately three months, were at 9.1 percent. Readings that are higher than 6.5 percent are indicative of type 2 diabetes. readings above 8 percent indicate that blood sugar levels could be more controlled. this can be associated with the increased risk of complications.

When the study researchers randomly assigned 116 people to make use of CGMs and 56 people to use traditional monitors of blood glucose over eight months. By the end of follow-up their average A1C levels of 8.4 percent blood sugar monitor without finger pricks in comparison to 8.4 percent for traditional monitors for blood glucose.

The reason for the different in results could be due to how frequently patients test their blood with their own devices. While the continuous glucose monitors utilized in the study analyzed the levels of blood sugar every 5 minutes, without any actions required by patients, patients who use traditional blood glucose monitors tested their blood sugar levels only 1.5 times a day , on average.

Roy Beck, MD, PhD is coauthor of the study and the president of Jaeb Center for Health Research Foundation, Tampa, Florida. He claims that glucose levels fluctuate a lot throughout the day, particularly in patients with insulin dependence. The one or two tests are usually not accurate for glucose levels at various times during the day.

"So those who use the blood glucose monitor one or two times a day often have no idea that their glucose levels might be rising substantially after an eating event," Dr. Beck states.

A Clinical Trial Shows the Benefits of Continuous Glucose Monitoring
The majority of the patients included in the study were taking basal insulin. These doses aim to maintain stable blood sugar levels during meals and over the course of the night. Prandial insulin is a fast-acting insulin that is taken right after meals to prevent the rapid fluctuation in blood sugar.

The study's drawbacks could mean that the findings could not be relevant to diabetics of type 2 who take both basal and prandial doses of insulin. Patients also had more supervision and support through the study than they would in real life, making the possibility that results could be different for people who use CGM in the real world -- that is, outside a clinical setting.

Another study has demonstrated that CGM can make a difference in people with type 2 diabetes who use insulin to manage their blood sugar. A different study published in JAMA, also on June 2, 2021, studied blood sugar levels for a year prior to and following the time when people who suffer from diabetes began using a CGM and discovered a significant benefit for people with type 1 and those with type 2 diabetes. The study examined data from 3,806 people who took CGM and 37.947 people who didn'tAll of whom were treated at Kaiser Permanente facilities located in Northern California between 2014-2019.

CGM can also be beneficial to the type 2 diabetes in a'real-world' study
Average A1C levels of CGM initiators decreased from 8.2 percent 12 months prior to beginning to 7.64 percent 12 months later. Over a similar 24-month window for non-initiators, their average A1C levels dropped much less by a factor of 8.27 percent to 8.18 percent.

Furthermore, the proportion of initiators with type 2 diabetes who reached A1C levels below 7 percent, which is the threshold at which the condition is considered to be well-managed and well controlled, increased from 19.7 percent in the 12 months prior to beginning to 32.2 percent in the 12 months following. The proportion of non-initiators with A1C levels below 7 percent crept up from 18.0 percent to 20.3 percent over the same 24-month window.

CGM was also linked to a decrease in hypoglycemia (dangerously low blood sugar levels) and hyperglycemia (dangerously high blood sugar levels) among type 2 diabetics.

This study has the advantage of being based upon real-world patient experiences. But a limitation of this analysis is that it wasn't an uncontrolled trial as the previously mentioned new study, and it's possible there are some unidentified variations between initiators and those who didn't that might explain their different results.
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