Effect of Flash Glucose Monitoring in T1DM Patients with Multiple Daily Insulin Injections:Improved HbA1C and Reduced Glycemic Variability

Background : Flash glucose monitoring(FGM) was introduced to China in 2016 and it might improve HbA1C and reduce glycemic variability for T1DM therapy. Methods : A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. Patients were randomly divided into FGM group or self-monitoring blood glucose(SMBG) group. Both groups wore the FGM for multiple 2 week periods, beginning with the 1st, 24th, and 48th week for gathering data,while blood samples were collected for HbA1c measurement. The dietary guidance and insulin dose adjustment were made in FGM group patients according to the dynamic blood glucose monitoring map as well as SMBG group patients according to SMBG measurements 3-4 times daily. All of the participants would insist on SMBG measurements in the days without wearing the FGM device. At the final visit, HbA1C,time in range(TIR),the duration of hypoglycemia and numbers of diabetic ketoacidosis(DKA) were taken as the main observational indexes. Results : There was no significant difference in baseline characteristics of the two groups. At 24 week,HbA1c level of FGM gruop was (8.16±1.03)%,much lower than that of SMBG group(8.68±1.01)%(p<0.05).Interquartile range(IQR),mean blood glucose(MBG),duration of hypoglycemia of FGM group also showed significant decline, compared with SMBG group(p<0.05),while TIR displayed apparently increase in FGM group [(49.39±17.54)% vs (42.44±15.49)%] (p<0.05). At 48 week,the differences were more pronounced (p<0.01).There was no observed change in the number of episodes of DKA when study was finished [(0. 25±0. 50) vs (0. 28±0. 51),P＝0.75]. Conclusion : Intermittent use of FGM in T1DM patients can improve HbA1c and glycemic control without increasing hypoglycemic exposure in insulin-treated type 1 diabetes individuals in the undeveloped country.