Effect of Continuous Glucose Monitoring on Glycemic Control in Patients With Type 2 Diabetes Treated With Basal Insulin

EN BREF ...

"A study based on National Health and Nutrition Examination Survey (NHANES) data between 2005 and 2012 estimated that approximately 30% of US residents with type 2 diabetes were treated with insulin, with about two-thirds using basal insulin without prandial insulin. Yet only 62% of individuals using insulin were estimated to have achieved a hemoglobin A1c (HbA1c) level of less than 8.0% and only 31% achieved a level of less than 7.0%. More recent evaluation of NHANES data suggests there had not been any improvement in diabetes glycemic outcomes in the US between 2005 and 2016. Glucose monitoring is central to safe and effective management for individuals with type 2 diabetes using insulin. Glucose management based on blood glucose meter (BGM) testing for individuals with type 2 diabetes using insulin has been demonstrated to be effective in treat-to-target trials and in observational studies,4 but other studies have documented that self-monitoring of blood glucose with self-titration of insulin was underutilized in routine practice. Real-time continuous glucose monitoring (CGM), by providing glucose measurements as often as every 5 minutes, low and high glucose alerts, and glucose trend information, has the potential to better inform diabetes management decisions compared with episodic self-monitoring with a BGM. Studies have demonstrated that CGM improved glycemic control in individuals with type 1 diabetes7-12 and with type 2 diabetes using insulin regimens with basal plus prandial insulin.The role of CGM in individuals with type 2 diabetes using less-intensive insulin regimens is not well defined. To evaluate the effectiveness of CGM in these patients, an 8-month randomized, multicenter, clinical trial was conducted comparing CGM vs BGM monitoring in patients with type 2 diabetes treated with basal insulin without prandial insulin whose diabetes was being managed by primary care clinicians." En bref issu de l'étude.