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This article is from the NEJM Journal Watch Continuous Glucose Monitoring in Type 2 Diabetes Patients with Basal-Only Insulin Regimens.
Commentary on continuous glucose monitoring in Type 2 Diabetes Patients with Basal-Only Insulin Regimens.
Author: Thomas L.
Schwenk, MD Accepts Continuous Patients with blood glucose monitoring (CGM) can achieve better blood glucose control, but the reason is unknown
.
For patients with type 2 diabetes who need intensive insulin therapy, CGM can improve their blood sugar control
.
In this multi-center study, the researchers explored the effect of CGM on primary care who only receive basal insulin therapy (1 or 2 doses of intermediate or long-acting insulin daily, and insulin should not be taken during meals), which is a lower-intensity treatment regimen for primary care Benefits for clinic patients
.
175 patients (average age, 57 years; average glycosylated hemoglobin [HbA1c], 9.
1%) were randomly assigned to CGM or conventional blood glucose meter (BGM)
.
In order to achieve the purpose of the study, this study collected blinded CGM results from patients in the BGM group; patients in the CGM group can obtain BGM readings as needed, and both groups of patients receive regular education and consultation
.
At 8 months, the average HbA1c of the CGM group was significantly lower than that of the BGM group (8.
0% vs.
8.
4%)
.
The proportion of time that the blood glucose of the CGM group was in the range of 70-180 mg/dL was significantly higher than that of the BGM group (59% vs.
43%)
.
During the study period, there was no change in the total daily insulin dose, and the total dose of the two groups was similar (about 0.
5 U/kg)
.
In addition, there was no difference in the addition or reduction of other diabetes drugs between the two groups
.
Adverse events of hypoglycemia were few and similar in both groups
.
Comments At first glance, the results of this study are encouraging regarding the value of CGM for type 2 diabetic patients receiving only basal insulin therapy
.
However, due to the fact that there was no difference in insulin dose changes between the two groups during the trial and the use of other hypoglycemic drugs, the comment writer made the following reasonable inference: The results of this study are due to the better treatment of patients in the CGM group (that is, the The patients in the group had higher compliance with diet, exercise and insulin dosage)
.
This observation raises the question of whether increased behavioral support for patients can achieve the same effect as CGM (the cost of which may be a barrier to patients)
.
Please note that this research is funded by the manufacturer of the CGM monitor, and several authors have received financial support from the company
.
Commented article Martens T et al.
Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: A randomized clinical trial.
JAMA 2021 Jun 8; 325:2262.
(https://doi.
org/ 10.
1001/jama.
2021.
7444)Peek ME and Thomas CC.
Broadening access to continuous glucose monitoring for patients with type 2 diabetes.
JAMA 2021 Jun 8; 325:2255.
(https://doi.
org/10.
1001/jama.
2021.
6208) Read the NEJM Journal Watch The NEJM Journal Watch is published by the NEJM Group.
Internationally renowned doctors are invited to comment on important papers in the medical field to help doctors understand and use the latest developments
.
"NEJM Frontiers of Medicine" is translated several times a week, published on the app and official website, and selected 2-3 articles are published on WeChat
.
Copyright information This article was translated, written or commissioned by the "NEJM Frontiers of Medicine" jointly created by the Jiahui Medical Research and Education Group (J-Med) and the "New England Journal of Medicine" (NEJM)
.
The Chinese translation of the full text and the included diagrams are exclusively authorized by the NEJM Group
.
If you need to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
cn
.
Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal liabilities
.
Commentary on continuous glucose monitoring in Type 2 Diabetes Patients with Basal-Only Insulin Regimens.
Author: Thomas L.
Schwenk, MD Accepts Continuous Patients with blood glucose monitoring (CGM) can achieve better blood glucose control, but the reason is unknown
.
For patients with type 2 diabetes who need intensive insulin therapy, CGM can improve their blood sugar control
.
In this multi-center study, the researchers explored the effect of CGM on primary care who only receive basal insulin therapy (1 or 2 doses of intermediate or long-acting insulin daily, and insulin should not be taken during meals), which is a lower-intensity treatment regimen for primary care Benefits for clinic patients
.
175 patients (average age, 57 years; average glycosylated hemoglobin [HbA1c], 9.
1%) were randomly assigned to CGM or conventional blood glucose meter (BGM)
.
In order to achieve the purpose of the study, this study collected blinded CGM results from patients in the BGM group; patients in the CGM group can obtain BGM readings as needed, and both groups of patients receive regular education and consultation
.
At 8 months, the average HbA1c of the CGM group was significantly lower than that of the BGM group (8.
0% vs.
8.
4%)
.
The proportion of time that the blood glucose of the CGM group was in the range of 70-180 mg/dL was significantly higher than that of the BGM group (59% vs.
43%)
.
During the study period, there was no change in the total daily insulin dose, and the total dose of the two groups was similar (about 0.
5 U/kg)
.
In addition, there was no difference in the addition or reduction of other diabetes drugs between the two groups
.
Adverse events of hypoglycemia were few and similar in both groups
.
Comments At first glance, the results of this study are encouraging regarding the value of CGM for type 2 diabetic patients receiving only basal insulin therapy
.
However, due to the fact that there was no difference in insulin dose changes between the two groups during the trial and the use of other hypoglycemic drugs, the comment writer made the following reasonable inference: The results of this study are due to the better treatment of patients in the CGM group (that is, the The patients in the group had higher compliance with diet, exercise and insulin dosage)
.
This observation raises the question of whether increased behavioral support for patients can achieve the same effect as CGM (the cost of which may be a barrier to patients)
.
Please note that this research is funded by the manufacturer of the CGM monitor, and several authors have received financial support from the company
.
Commented article Martens T et al.
Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin: A randomized clinical trial.
JAMA 2021 Jun 8; 325:2262.
(https://doi.
org/ 10.
1001/jama.
2021.
7444)Peek ME and Thomas CC.
Broadening access to continuous glucose monitoring for patients with type 2 diabetes.
JAMA 2021 Jun 8; 325:2255.
(https://doi.
org/10.
1001/jama.
2021.
6208) Read the NEJM Journal Watch The NEJM Journal Watch is published by the NEJM Group.
Internationally renowned doctors are invited to comment on important papers in the medical field to help doctors understand and use the latest developments
.
"NEJM Frontiers of Medicine" is translated several times a week, published on the app and official website, and selected 2-3 articles are published on WeChat
.
Copyright information This article was translated, written or commissioned by the "NEJM Frontiers of Medicine" jointly created by the Jiahui Medical Research and Education Group (J-Med) and the "New England Journal of Medicine" (NEJM)
.
The Chinese translation of the full text and the included diagrams are exclusively authorized by the NEJM Group
.
If you need to reprint, please leave a message or contact nejmqianyan@nejmqianyan.
cn
.
Unauthorized translation is an infringement, and the copyright owner reserves the right to pursue legal liabilities
.
