Conexiant’s news site is now MDSpire News. Learn more
Advertisement
CGM Linked to More Time in Range
In a randomized crossover trial of insulin-treated patients receiving hemodialysis, real-time continuous glucose monitoring did not improve the primary hypoglycemia outcome but increased time in range and reduced time above range vs capillary testing.
To evaluate the impact of real-time continuous glucose monitoring (CGM) on glycemic control in patients with insulin-treated type 2 diabetes receiving maintenance hemodialysis.
Approach:
Study Design: A prospective, randomized crossover trial conducted at Emory Healthcare dialysis centers involving patients aged 18 to 80 with type 2 diabetes and end-stage kidney failure.
Participants: 52 enrolled patients, with 39 included in the modified intention-to-treat analysis after exclusions.
Intervention: Participants used the Dexcom G6 CGM for 30 days followed by a washout and crossover to standard capillary blood glucose testing.
Outcomes: Primary outcome was time below 70 mg/dL; secondary outcomes included time in range (70-180 mg/dL), time above 180 mg/dL, mean glucose, and measures of hypo- and hyperglycemia.
Key Findings:
Time below 70 mg/dL did not differ significantly between CGM (1.2%) and capillary testing (1.3%).
Mean time in the target range was higher with CGM (63%) compared to capillary testing (55%).
Mean glucose was lower during CGM (174 mg/dL) compared to capillary testing (188 mg/dL).
Hyperglycemic episodes remained common, with 95% of patients experiencing glucose above 250 mg/dL during CGM.
Interpretation:
Real-time CGM improved secondary glycemic measures but did not significantly reduce hypoglycemia rates.
Limitations:
Small sample size and inclusion of only insulin-treated patients.
Low time below range limited the potential for improvement in the primary outcome.
Challenges in conducting research in a medically complex population.
Conclusion:
Real-time continuous glucose monitoring improved time in range and reduced time above range during the intervention.
These 10 states have paid family or medical leave programs and health, wellness, peer support, or monitoring resources available to physicians or other health professionals.
Investigators examined Life’s Essential 8 scores and carotid ultrasonography measures across cardiovascular-kidney-metabolic stages in 1,283 young adults.
