Background: There has been a change in the management of type 1 diabetes (T1D) with the availability of continuous glucose monitoring (CGM) systems. In Australia, subsidized CGM is available to patients below the age of 21. A randomized controlled trial (RCT) evaluating hybrid closed loop therapy is currently underway and the baseline data provided an opportunity to analyze the glycemic patterns in patients on contemporary management.
Methods: Adolescents and young adults with T1D and HbA1c <10.5% were eligible. All participants wore masked CGM (Enlite® Sensor 3, Medtronic) for 3 weeks during the run-in period. Glucose data from masked CGM were evaluated for glycemic patterns including sensor glucose (SG), glucose variability, percentage time in range, time in hypoglycemia and hyperglycemia.
Results: Data were analyzed from 100 participants (47M, 53F; pump 80, MDI 20) with (mean±SD) age 14.9±2.7 years, diabetes duration 7.6±0.9 years, HbA1c 7.9±0.9% of which 55% participants were on real-time CGM. The (mean±SD) SG was 9.6±1.6mmol/l with fasting SG of 8.8±1.9mmol/l. The SG coefficient of variation was 41.3±6.04%. The median [IQR] %time in range (3.9 to 10mmol/l) was 55.9 [44.1,62.3]. The %time in hypoglycemia (<3.0 and < 3.9mmol/l) were 1.1[0.3,2.2] and 4.4[2.2,8.6] respectively. The %time in hyperglycemia (>10 and >13.9mmol/l) were 35.5[24.7,45.7] and 14.1[8.1,18.8] respectively.
Conclusion: Majority of adolescents in the trial were on insulin pump therapy with half of them on CGM. The baseline CGM data of these participants provide a snapshot of the glycemic management in patients with T1D on current therapy; especially highlighting the reduced time in hypoglycemia compared to earlier trials. The data can further inform the conduct of future trials.
M.B. Abraham: None. G.J. Smith: None. M. de Bock: None. B.R. King: None. J. Fairchild: None. G. Ambler: None. F. Cameron: None. E.A. Davis: None. D.N. ONeal: None. T. Jones: Research Support; Self; Dexcom, Inc., Medtronic MiniMed, Inc. Speaker's Bureau; Self; Eli Lilly and Company, Roche Diabetes Care.