Discussion
T1D, hypoglycemia, diabetes
HYPOGLYCEMIA, EVENTS, DIABETES
This prospective, randomized study was conducted to compare the unblinded and blinded isCGM glucose profiles in adults with T1D, and the findings showed that over 12 weeks of isCGM use is beneficial in the management of T1D.Clinical application of CGM has been generally indicated to result in a significant improvement in diabetes management (Real-time CGM devices enable patients to respond immediately to mitigate or prevent acute glycemic events and allow patients to make better informed decisions about their medication requirements and other areas of their daily diabetes self-management. In the IMPACT study, the use of an intermittently viewed system was associated with a reduction in hypoglycemia as compared with a conventional SMBG device in adults with well-controlled T1D (Unlike unblinded isCGM, blinded isCGM can automatically transmit data to the patient’s receiver and provides blinded retrospective data for up to 14 days (According to recent international consensus, individuals with T1D should strive to achieve 4% of time below the target range (<3.9 mmol/L), >70% of time within the target range (3.9–10.0 mmol/L), and <25% above the range (>10.0 mmol/L), with a glycemic variability (%CV) of <36% (In the present study, we found that that 99.5% of the blinded isCGM values were obtained, compared with only 93.8% of the unblinded isCGM values at the final visit. The data showed that the majority of scanning was conducted during the awake hours spanning 6–18 h, while only a few scans were performed over the night-time hours spanning 0–6 h. The possible reasons for missing data in the unblinded isCGM group may be scanning frequency and the time of day for measurements according to the patient’s age, lifestyle, eating habits, level of physical activity, and understanding and motivation with regard to maintenance of glucose monitoring (Diet, physical exercise, and psychological reactions are important components in the management of T1D across a patient’s lifespan (A major limitation of our study is that the intervention period of 12 weeks is relatively short. An extended monitoring period may provide insight into longer-term use of CGM and reflect the real-world setting. Additionally, these results also need to be confirmed in a large study population.In conclusion, the use of isCGM systems resulted in a decrease in HbA1c level over 12 weeks among the adults with T1D in this study. The unblinded isCGM system was associated with benefits for glucose management, but with the blinded system, nearly 100% of the profiles were obtained successfully. It appears that the blinded isCGM systems can overcome both expected and unexpected data collection hurdles. Thus, combining both real-time and retrospective data gathered by isCGM might be the most appropriate and impactful way to utilize flash glycemic monitoring devices. However, further research is needed to understand the clinical importance of this finding and the applicability of these systems in the real world.