A Randomized Controlled Trial Using Continuous Glucose Monitoring to Guide Food Choices and Diabetes Self-Care in People with Type 2 Diabetes not Taking Insulin

被引:0
作者
Martens, Thomas W. [1 ,2 ]
Willis, Holly J. [1 ]
Bergenstal, Richard M. [1 ]
Kruger, Davida F. [3 ]
Karslioglu-French, Esra [4 ]
Steenkamp, Devin W. [5 ]
机构
[1] HealthPartners Inst, Int Diabet Ctr, Suite 600,Mailstop 61N06A,3800 Pk Nicollet Blvd,St, Minneapolis, MN 55416 USA
[2] Pk Nicollet Clin, Dept Internal Med, Minneapolis, MN USA
[3] Henry Ford Hlth Syst, Detroit, MI USA
[4] Univ Pittsburgh, Med Ctr Presbyterian, Pittsburgh, PA USA
[5] Boston Univ, Boston Med Ctr, Chobanian & Avedisian Sch Med, Boston, MA USA
关键词
CGM; type; 2; diabetes; time in range; time above range; noninsulin medications; dietary nutrition;
D O I
10.1089/dia.2024.0579
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Continuous glucose monitoring (CGM) is an effective tool for individuals with type 2 diabetes (T2D) on insulin. This study evaluated the effect of using CGM to reduce hyperglycemia, by focusing on food and lifestyle choices, in people with T2D not taking insulin. Methods: A 6-month randomized, prospective four-center study was conducted. The primary end point was a within-group reduction in time above range >180 mg/dL (TAR180) at 3 months. Participants were asked not to make diabetes medication changes in the first 3 months. Seventy-two adults not on insulin or sulfonylurea therapy, with glycated hemoglobin (HbA1c) 7.5%-12%, were randomized to use CGM alone (n = 31) or CGM plus a food logging app (n = 41) to aid diabetes management. Participants attended guided education visits. Differences in CGM metrics, HbA1c, and body weight were compared. Results: The CGM alone group decreased TAR180 from 55% at baseline to 27% at 3 months (P < 0.001) and 21% at 6 months (P < 0.001); the CGM plus food logging app group decreased TAR180 from 53% at baseline to 30% at both 3 and 6 months (P < 0.001 for both). For all participants, time in range (70-180 mg/dL) increased from 46% at baseline to 71% at 3 months (P < 0.001) and to 72% at 6 months (P < 0.001). HbA1c and weight were reduced by 1.3% (P < 0.001) and 7 pounds (lbs.) (P < 0.001) for all participants at 6 months. Conclusion: People with T2D not taking insulin showed large, clinically significant improvements in CGM metrics and HbA1c when using either CGM alone or with a food logging app. This occurred with a near absence of medication changes in the first 3 months and were therefore likely due to changes in food and/or lifestyle choices.
引用
收藏
页码:261 / 270
页数:10
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