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The Effect of Discontinuing Continuous Glucose Monitoring in Adults with Type 2 Diabetes Treated with Basal Insulin

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posted on 29.09.2021, 18:17 by Grazia Aleppo, Roy W. Beck, Ryan Bailey, Katrina J. Ruedy, Peter Calhoun, Anne L. Peters, Rodica Pop-Busui, Athena Philis-Tsimikas, Shichun Bao, Guillermo Umpierrez, Georgia Davis, Davida Kruger, Anuj Bhargava, Laura Young, Janet B. McGill, Thomas Martens, Quang T. Nguyen, Ian Orozco, William Biggs, K. Jean Lucas, William H. Polonsky, John B. Buse, David Price, Richard M. Bergenstal, the MOBILE Study Group
Objective: To explore the effect of discontinuing continuous glucose monitoring (CGM) after 8 months of CGM use in adults with type 2 diabetes treated with basal without bolus insulin.

Research Design and Methods: Multi-center trial with an initial randomization to either real-time CGM or blood glucose monitoring (BGM) for 8 months, followed by 6 months in which the BGM Group continued to use BGM (N=57) and the CGM Group was re-randomized either to continue CGM (N=53) or discontinue CGM with resumption of BGM for glucose monitoring (N=53).

Results: In the group that discontinued CGM, mean time in range 70-180 mg/dL (TIR), which improved from 38% prior to initiating CGM to 62% after 8 months of CGM, decreased after discontinuing CGM to 50% at 14 months (mean change from 8 to 14 months = -12%, 95% CI -21% to -3%, P=0.01). In the group continuing CGM, there was little change in TIR from 8 to 14 months (baseline 44%, 8 months 56%, 14 months 57%; mean change 8 to 14 months = 1%, 95% CI -11% to 12%, P=0.89). Comparing the two groups at 14 months, the adjusted treatment group difference in mean TIR was -6% (95% CI -16% to 4%, P=0.20).

Conclusions: In adults with type 2 diabetes treated with basal insulin who had been using real-time CGM for 8 months, discontinuing CGM resulted in a loss of about half of the initial gain in TIR that had been achieved during CGM use.

Funding

Study funding and study devices were provided by Dexcom, Inc.

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