Continuous glucose monitors help control type 2 diabetes


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In patients with insulin-treated type 2 diabetes, the use of continuous glucose monitors is associated with better blood sugar control and fewer emergency room visits for hypoglycemia, according to a study by Kaiser Permanente published on 2 of June in the magazine. JAMA Found.

Monitors have previously shown that they improve for patients with type 1 diabetes. Continuous glucose monitors are now the standard care for these patients.

“Improving a it was comparable to what a patient might experience after starting a new diabetes drug, “said study lead author Andrew J. Karter, Ph.D., a senior researcher in Kaiser’s Permanent Research Division in northern California.

The retrospective and comparative efficacy study included 5,673 patients with type 1 diabetes and 36,080 patients with type 2 diabetes treated with insulin and self-sufficiency. theirs . Between January 2015 and December 2019, on the recommendation of their doctors, 3,462 patients with type 1 diabetes and 344 with type 2 diabetes began using continuous glucose monitors.

Using statistical techniques that mimicked chance in a clinical trial, the researchers evaluated the results before and after patients who started using a continuous glucose monitor compared to the results of patients who did not. These analyzes showed that continuous glucose monitors were associated with decreased HbA1c levels, a laboratory test used in the diagnosis and treatment of diabetes that measures levels. Monitors also reduced emergency department visits and hospitalizations for hypoglycemia or a very low blood sugar level. Hypoglycemia increases the risk of falls, cardiovascular disease, dementia and death.

“Blood sugar levels that are too low can be dangerous,” said study lead author Richard Dlott, MD, endocrinologist and director of population care at The Permanente Medical Group. “This study shows that continuous glucose monitors helped people stay close to glucose targets without dropping too much.”

For decades, people with diabetes have used finger sticks to test blood sugar levels. Since 2017, Medicare has covered the cost of continuous glucose monitors for patients with diabetes who meet certain qualifications. (Today, almost everyone with type 1 diabetes is classified.) Continuous glucose monitors use a thin metal sensor to detect blood sugar levels just under the skin. The sensor transmits blood sugar readings every 5 minutes to a receiver or smartphone. Continuous glucose monitors are only available by prescription.

The study examined patients with diabetes who began using continuous glucose monitors as prescribed by their doctor. To meet the requirements of the Medicare guidelines, patients generally need to take 3 or more injections of insulin daily or use an insulin pump, perform blood glucose tests four or more times a day, and communicate. is constantly with a diabetic team every 3 to 6 months.

“The selective prescription of continuous glucose monitors may partially explain the benefits we have seen in these patients with type 2 diabetes,” said Karter, who is also the associate director of the Center for Health Delivery Systems for Translational Research. of Diabetes, sponsored by the National Diabetes Institute. and Digestive and renal diseases. “Doctors appeared to have preferably prescribed monitors to patients with a history of hypoglycemia or at high risk of hypoglycemia.”

Researchers say the next step is to determine if there are other patients with type 2 blood sugar would be better and safer controlled with continuous glucose monitors. “This study found that patients who used continuous the monitors had very good results compared to those who only continued to do intermittent tests with finger sticks, “Dr. Dlott said.” Now we have to determine if there are others who may also benefit, even if they do not meet all Medicare criteria. Newer technology is not always better for everyone. We need to identify the people who are most likely to benefit. ”

The custom sweat sensor reliably monitors blood glucose without finger punctures

More information:
Carter AJ et al. Association of continuous real-time glucose monitoring with glycemic control and acute metabolic events among patients with insulin-treated diabetes. JAMA. Published online June 2, 2021. DOI: 10.1001 / jama.2021.6530

Provided by
Kaiser Permanent

Citation: Continuous glucose monitors help control type 2 diabetes (2021, June 2) recovered on June 2, 2021 at

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