Background: Continuous glucose monitoring (CGM) can decrease fear of hypoglycaemia (FOH) and improve glycaemic control among those affected by type 1 diabetes (T1D). No studies to date have examined the impact of using Do-It-Yourself Real-Time Continuous Glucose Monitoring (DIY RT-CGM) on psychological and glycaemic outcomes. The primary aim of this study was to investigate the effect of DIY RT-CGM compared to intermittently scanned CGM (isCGM) on parental FOH.
Methods: Child-parent dyads were recruited for this multicentre randomised crossover trial. Children with T1D were aged 2-13 years and were current isCGM users. Families had 6 weeks of using DIY RT-CGM with parental remote monitoring (intervention) and 6 weeks of isCGM plus usual diabetes care (control) in a random order with a four-week washout period. FOH was assessed by the hypoglycaemia fear survey. Standard CGM based glycaemic variables were collected via Tidepool. Parental satisfaction was assessed by the diabetes treatment satisfaction questionnaire (DTSQ).
Results: The study included 55 child-parent dyads; child mean age 9.1±2.8 years. There was no evidence of an effect on parental FOH, -0.1 (95% CI: -0.3, 0.1, p-value 0.4). Time-in-range (%3.9-10mmol/L) favoured DIY RT-CGM over isCGM (54.3%±13.7 vs. 48.1%±13.6), adjusted mean difference, 5.7% (95% CI 1.8, 9.6, p-value 0.004). There was no evidence of a difference between DIY RT-CGM and isCGM for time spent in hypoglycaemia. Parents reported higher DTSQ scores following DIY RT-CGM compared to isCGM, adjusted mean difference 5.3 (95% CI: 2.3, 8.2, p-value <0.001).
Conclusion: The use of DIY RT-CGM versus isCGM did not improve parental FOH, however time in range and parental satisfaction with diabetes treatment were significantly improved, suggesting DIY RT-CGM with remote monitoring may offer families clinically important benefits over isCGM in regards to these aspects of T1D management.
M. Elbalshy: None. B. J. Wheeler: Research Support; Self; Dexcom, Inc., i-SENS, Inc., Medtronic, Ypsomed Group. S. Styles: None. J. J. Haszard: None. B. Galland: None. H. Crocket: None. C. A. Jefferies: None. E. Wiltshire: None. P. Tomlinson: None. M. De bock: None.