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What I Learned Tracking My Blood Sugar \u0026 Why You Should Too (Levels Health CGM)Hypoglycemia and blood glucose monitors -
Prespecified secondary HbA 1c outcomes included mean change from baseline, percentage with HbA 1c less than 7. org ] Emotion Battery , hypoglycemia awareness Clarke Survey 16 , hypoglycemia fear Hypoglycemia Fear Survey II—Worry subscale 17 , and diabetes distress Type 1 Diabetes Distress Scale Descriptions of these outcomes, scoring, and clinically relevant change when known are shown in eTable 2 in Supplement 2.
Cognitive performance also was assessed at baseline and 26 weeks using the NIH Toolbox Cognition Battery; specifics on this measure and training of study personnel are also described in eTable 2.
Reportable adverse events included severe hypoglycemia defined as an event that required assistance from another person because of altered consciousness , hyperglycemia resulting in treatment at a health care facility or that involved diabetic ketoacidosis as defined by the Diabetes Control and Complications Trial 19 , device-related events with potential effect on participant safety, falls, fractures, emergency department visits, and all serious adverse events regardless of causality.
Participants were analyzed according to their randomization group, and all participants were included in the primary analysis. Missing data were handled by direct likelihood, which maximizes the likelihood function integrated over possible values of the missing data.
Binary HbA 1c outcomes were compared between treatment groups using available cases only in a logistic regression model adjusting for baseline HbA 1c and clinical center as a random effect. Modification of the treatment effect by baseline variables was assessed by including an interaction term in the primary model.
Sensitivity analyses were performed as described in the statistical analysis plan adjustment for potential confounding of baseline imbalances and including only participants meeting per-protocol criteria Supplement 1.
Analysis of all outcomes was repeated separately among insulin pump and injection users and paralleled the overall analysis described above.
Additional analyses also were performed for data collected through 16 weeks and data collected separately during daytime am to pm and nighttime am to am hours for CGM outcomes. Analyses were conducted with SAS software version 9. Sixteen patients who provided consent and were screened for the study did not proceed into the randomized clinical trial Figure 1.
Participant characteristics overall and according to randomization group are shown in Table 1 and additionally stratified by insulin delivery method in eTable 4 in Supplement 2. Participant comorbidities and medications are reported in eTables 5 and 6 and in Supplement 2 , respectively. Unscheduled visits and contacts are reported in eTable 7 in Supplement 2.
In the CGM group, CGM use was high throughout the study eTable 8 in Supplement 2. Use of CGM was similar between those who used a pump and those who used injections for insulin delivery eTable 9 in Supplement 2. Two participants in the standard BGM group initiated real-time CGM use during the trial.
Results were similar for other CGM hypoglycemia metrics Table 2 and eTable The significant treatment effect was evident in the first month and remained consistent over 6 months Figure 2 A and eTable 11 in Supplement 2.
Results were similar in a sensitivity analyses that adjusted for characteristics with some imbalance at baseline duration of diabetes, sex, education, severe hypoglycemia in the 12 months prior to the study, and functional activity [questionnaire score] and in a per-protocol sensitivity analysis eTable 12 in Supplement 2.
Mean HbA 1c was 7. Additional HbA 1c metrics are shown in eTable 17 in Supplement 2. One participant in the CGM group and 10 participants in the standard BGM group experienced a severe hypoglycemia event during the 6 months of follow-up Table 3.
One episode of diabetic ketoacidosis occurred during the study in a participant in the CGM group, unrelated to use of CGM Table 3. There were no statistically significant treatment group differences in fractures, falls, hospitalizations, or emergency department visits.
There were 22 CGM device issues reported over the week follow-up eTable 18 in Supplement 2 , none of which were related to an adverse event. No significant treatment group differences were observed at 26 weeks for any of the participant-reported questionnaires or cognitive assessments, including measures of hypoglycemia awareness, diabetes-specific quality of life hypoglycemia fear, diabetes distress, and glucose monitoring satisfaction , general quality of life, and cognition eTable 19 in Supplement 2.
A similar degree of hypoglycemia reduction was seen in those using insulin pump therapy and those using multidose insulin injection therapy. Results were consistent across the age range of 60 to 86 years, across the baseline HbA 1c range of 5.
The higher the amount of baseline hypoglycemia and glycemic variability, risk factors for severe hypoglycemia in older adults with type 1 diabetes, 22 the greater the treatment effect. Despite improvements in various measures of hypoglycemia and glycemic control and the high degree of CGM use after 6 months, there were no significant treatment group differences in patient-reported outcomes, including fear of hypoglycemia and diabetes distress.
One possible explanation is that the baseline scores on these measures were quite low, indicating already good adjustment to managing diabetes. The findings in this trial are consistent with a subgroup analysis of the participants in the DIAMOND study, who were aged 60 years or older, with respect to the high degree of CGM use after 6 months and the benefit of CGM on reducing hyperglycemia and HbA 1c ; however, the DIAMOND cohort had too little baseline hypoglycemia for a meaningful assessment of the effect of CGM on hypoglycemia.
The strengths of this study include random treatment assignment, high participant retention rate, high degree of CGM use by the CGM group, and only 2 treatment crossovers by the standard BGM group. Although treatment group assignment could not be masked, the amount of contact with participants was similar between groups.
This study has several limitations. First, the study cohort had relatively high socioeconomic status and consisted of individuals receiving specialized diabetes care. On average, baseline glycemic control was good and the amount of biochemical hypoglycemia was modest.
Median age at diagnosis was 30 years, but the treatment effect appeared similar irrespective of age at diagnosis. Second, there was a relatively short intervention period of 6 months. This study included an extension phase during which the CGM group continued using CGM through 12 months and the standard BGM group initiated CGM.
Results of the extension phase may provide insight into longer-term use of CGM. Third, the study intervention used an older version of the CGM sensor than what is now commercially available.
It is unknown whether the additional features of the newer CGM sensor such as no calibration requirement, easier insertion process, and a predictive low glucose alert would have further increased CGM use in this population.
Fourth, the study intervention also did not include a system that suspends insulin delivery from a pump when hypoglycemia is predicted based on the CGM glucose readings. Such a system for pump users might have an even greater effect on reducing hypoglycemia than was seen in this study.
Among adults aged 60 years or older with type 1 diabetes, CGM compared with standard BGM resulted in a small but statistically significant improvement in hypoglycemia over 6 months. Corresponding Author: Richard E. Pratley, MD, AdventHealth Translational Research Institute, E Princeton St, Orlando, FL richard.
md adventhealth. Author Contributions: Dr Miller had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Pratley, Rickels, Ahmann, Aleppo, Beck, Carlson, Chaytor, Fox, Goland, Hirsch, Kruger, Kudva, Peters, Pop-Busui, Shah, Verdejo, Miller.
Acquisition, analysis, or interpretation of data: Pratley, Kanapka, Rickels, Ahmann, Aleppo, Bhargava, Bode, Carlson, Chaytor, Fox, Goland, Hirsch, Kruger, Kudva, Levy, McGill, Peters, Philipson, Philis-Tsimikas, Pop-Busui, Shah, Thompson, Vendrame, Weinstock, Miller.
Drafting of the manuscript: Pratley, Kanapka, Rickels, Carlson, Kudva, Peters, Philis-Tsimikas, Thompson, Miller. Critical revision of the manuscript for important intellectual content: Pratley, Kanapka, Rickels, Ahmann, Aleppo, Beck, Bhargava, Bode, Carlson, Chaytor, Fox, Goland, Hirsch, Kruger, Kudva, Levy, McGill, Peters, Philipson, Philis-Tsimikas, Pop-Busui, Shah, Vendrame, Verdejo, Weinstock.
Administrative, technical, or material support: Rickels, Beck, Bode, Carlson, Chaytor, Goland, Philipson, Vendrame, Verdejo, Miller. Supervision: Pratley, Rickels, Ahmann, Aleppo, Beck, Carlson, Chaytor, Goland, Hirsch, Kudva, Levy, Peters, Philipson, Vendrame, Weinstock, Miller.
Dr Ahmann reported contract research payments to his institution from Dexcom and receipt of personal fees from Medtronic. Dr Aleppo reported receipt of grants from Novo Nordisk, Dexcom, AstraZeneca, and Lilly and personal fees from Dexcom, Medtronic, Insulet, and Novo Nordisk. Dr Beck reported consulting fees paint to his institution from Bigfoot Biomedical, Tandem Diabetes Care, Insulet, and Lilly and receipt of grants from Dexcom and Tandem Diabetes Care and nonfinancial support from Dexcom, Tandem Diabetes Care, Roche, and Ascensia.
Dr Chaytor reported receipt of personal fees from Lilly. Dr Kruger reported receipt of grants and personal fees from Dexcom. Dr Levy reported receipt of nonfinancial support from Dexcom.
Dr McGill reported receipt of personal fees from Aegerion, Bayer, Boehringer Ingelheim, Gilead, Lilly, Metavant, Valeritas, Janssen, Mannkind, the Endocrine Society, the American Association of Clinical Endocrinologists, Culinary Medicine, Novo Nordisk, and Dexcom; grants from Novo Nordisk, Dexcom, Medtronic, Novartis, AstraZeneca, and the NIH; and nonfinancial support from Bayer, Boehringer Ingelheim, the American Association of Clinical Endocrinologists, Mannkind, Culinary Medicine, and the Jaeb Center for Health Research.
Dr Peters reported receipt of personal fees from Medscape, Sanofi, Lexicon, Becton Dickinson, Abbot Diabetes Care, Bigfoot, Mannkind, Novo Nordisk, Lilly, and Boehringer Ingelheim; grants from AstraZeneca, vTv Therapeutics, Mannkind, and Dexcom; and stock options for Mellitus Health, Omada Health, Stability Health, Pendulum Therapeutics, and Livongo.
Dr Shah reported receipt of consulting fees through the University of Colorado from Dexcom and grants from vTv therapeutics, Novo Nordisk, Mylan GmbH, Sanofi US Services Inc, Insulet, and the NIH.
Dr Weinstock reported receipt of grants from the Juvenile Diabetes Research Foundation, Insulet Corporation, Tolerion Inc, Lilly, Medtronic, Diasome Pharmaceuticals, Boehringer Ingelheim, Oramed Ltd, and Mylan GmbH and personal fees from Insulogic.
Dr Miller reported receipt of nonfinancial support from Dexcom and Tandem. No other disclosures were reported. and Harry B. Helmsley Charitable Trust by a grant provided to the Jaeb Center for Health Research.
The National Center for Research Resources and the National Center for Advancing Translational Sciences of the NIH grant UL1TR support the Center for Human Phenomic Science at the University of Pennsylvania.
Dexcom provided study CGM devices and sensors. Helmsley Charitable Trust, and Dexcom were not involved in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or in writing the original manuscript draft or revision of the manuscript.
JDRF, the Leona M. Helmsley Charitable Trust, and Dexcom were sent the manuscript for review, but any revisions made based on their comments were at the discretion of the authors, and permission for submitting content to the journal was not required.
There was no approval of JDRF, the Leona M. Helmsley Charitable Trust, or Dexcom required or obtained for manuscript submission. WISDM Study Group: Participating principal investigators PIs , coinvestigators Is , primary coordinator PCs , and coordinators Cs are listed below.
All study personnel listed below were involved in data collection. Additional roles beyond data collection are noted. Miller, PhD; Alandra Verdejo, MPH; Nicole Reese, BS; David McNabb, AS; Heidi Strayer, PhD; Kamille Janess, BS; Israel Mahr, MS; Lauren Kanapka, MSc; Craig Kollman, PhD; Roy Beck, MD, PhD; WISDM Operations committee members: Richard Pratley, MD; Michael Rickels, MD, MPH; Naomi Chaytor, PhD; D.
Steven Fox, MD; Kellee M. Miller, PhD; Data and Safety Monitoring Board: Mark Espeland, PhD, FASA chair ; Guillermo Umpierrez, MD, CDE; Mary Korytkowski, MD; Matthew Gilbert, DO. Meeting Presentation: The trial results were presented at the American Diabetes Association meeting in San Francisco, California, on June 9, , and at the European Association for the Study of Diabetes meeting in Barcelona, Spain, on September 17, Data Sharing Statement : See Supplement 3.
full text icon Full Text. Download PDF Top of Article Key Points Abstract Introduction Methods Results Discussion Conclusions Article Information References. Visual Abstract. Continuous Glucose Monitoring and Hypoglycemia in Older Adults With Type 1 Diabetes.
View Large Download. Figure 1. Flow of Participants in the Wireless Innovation for Seniors With Diabetes Mellitus WISDM Study. a Information on patients screened but not enrolled was not collected.
Figure 2. Table 1. Baseline Characteristics of Study Participants. Table 3. Safety Outcomes: Severe Hypoglycemia and Other Adverse Events.
Supplement 1. Trial Protocol and Statistical Analysis Plan. Supplement 2. eTable 1. Eligibility and Exclusion Criteria eTable 2. Description of Cognitive Assessment and Patient-Reported Outcomes eTable 3.
Multiple Comparisons Summary eTable 4. Baseline Characteristics by Pump and MDI Users eTable 5. Comorbidities at Enrollment eTable 6. Types of Medications at Enrollment eTable 7.
Unscheduled Contacts eTable 8. Real-time CGM Use eTable 9. Real-time CGM Use by Pump and MDI Users eTable CGM Metrics in Time per Day eTable Glycemic Outcomes at 16 Weeks eTable CGM Metrics During the Daytime AMPM and Nighttime AMAM eTable Glycemic Outcomes Among Participants Using a Pump for Insulin Delivery eTable Glycemic Outcomes Among Participants Using Injections for Insulin Delivery eTable Binary HbA1c Outcomes eTable Device Issues eTable Cognitive Assessment and Patient-Reported Outcomes eFigure 1.
Visit Completion by Treatment Group eFigure 2. CGM Education Materials eReferences. Supplement 3. Data Sharing Statement. Secrest AM, Becker DJ, Kelsey SF, LaPorte RE, Orchard TJ.
All-cause mortality trends in a large population-based cohort with long-standing childhood-onset type 1 diabetes: the Allegheny County type 1 diabetes registry. doi: Lipska KJ, Ross JS, Wang Y, et al. National trends in US hospital admissions for hyperglycemia and hypoglycemia among Medicare beneficiaries, to Stahn A, Pistrosch F, Ganz X, et al.
Relationship between hypoglycemic episodes and ventricular arrhythmias in patients with type 2 diabetes and cardiovascular diseases: silent hypoglycemias and silent arrhythmias. Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range.
Weinstock RS, Xing D, Maahs DM, et al; T1D Exchange Clinic Network. Severe hypoglycemia and diabetic ketoacidosis in adults with type 1 diabetes: results from the T1D Exchange Clinic Registry. Aleppo G, Ruedy KJ, Riddlesworth TD, et al; REPLACE-BG Study Group.
REPLACE-BG: a randomized trial comparing continuous glucose monitoring with and without routine blood glucose monitoring in adults with well-controlled type 1 diabetes. Tamborlane WV, Beck RW, Bode BW, et al; Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group.
Continuous glucose monitoring and intensive treatment of type 1 diabetes. Battelino T, Phillip M, Bratina N, Nimri R, Oskarsson P, Bolinder J.
Effect of continuous glucose monitoring on hypoglycemia in type 1 diabetes. Ruedy KJ, Parkin CG, Riddlesworth TD, Graham C; DIAMOND Study Group. Continuous glucose monitoring in older adults with type 1 and type 2 diabetes using multiple daily injections of insulin: results from the DIAMOND trial.
Lind M, Polonsky W, Hirsch IB, et al. Continuous glucose monitoring vs conventional therapy for glycemic control in adults with type 1 diabetes treated with multiple daily insulin injections: the GOLD randomized clinical trial.
Davis SN, Horton ES, Battelino T, Rubin RR, Schulman KA, Tamborlane WV. STAR 3 randomized controlled trial to compare sensor-augmented insulin pump therapy with multiple daily injections in the treatment of type 1 diabetes: research design, methods, and baseline characteristics of enrolled subjects.
Little SA, Leelarathna L, Walkinshaw E, et al. Recovery of hypoglycemia awareness in long-standing type 1 diabetes: a multicenter 2×2 factorial randomized controlled trial comparing insulin pump with multiple daily injections and continuous with conventional glucose self-monitoring HypoCOMPaSS.
The exact schedule you will follow depends on several different factors. See 'Frequency of glucose testing' below. Glucose monitoring can be done in two ways, blood glucose monitoring BGM and continuous glucose monitoring CGM. Blood glucose monitoring — BGM requires fingersticks to get small samples of blood.
The glucose level in the blood sample is measured with a glucose meter. The detailed steps for checking blood glucose through BGM are described below.
See 'How to check your blood glucose' below. Continuous glucose monitoring — CGM systems use a sensor to measure the level of glucose in the fluid under the skin. The sensor is attached to a transmitter placed on your skin, which is held in place with a sticky patch figure 1. It wirelessly transmits results to a small recording device no larger than a cell phone or to a smartphone or other smart device.
In some cases, it transmits the information directly to an insulin pump figure 2. You can attach the recording device to your clothing, carry it in a purse or bag, or place it near you eg, on a bedside table.
If you use a CGM system, you will need to remove the sensor and replace it on a different part of your body approximately once every 7 to 14 days.
Different CGM systems are available; one implantable sensor can last up to days, but it needs to be inserted and removed by a physician, nurse practitioner, or physician assistant.
FREQUENCY OF GLUCOSE TESTING. Studies have proven that people with diabetes who maintain normal or near-normal blood glucose levels reduce their risk of diabetes-related complications. Checking your glucose levels can play an important role in achieving your glucose goals and reducing the risk of complications.
See "Patient education: Preventing complications from diabetes Beyond the Basics ". Type 1 diabetes — For people with type 1 diabetes, frequent glucose testing is the only way to safely and effectively manage blood glucose levels.
People with type 1 diabetes may use blood glucose monitoring BGM with fingersticks and a glucose meter, or continuous glucose monitoring CGM. In people with type 1 diabetes, CGM is generally used if available and affordable. See 'Methods of glucose monitoring' above and 'Continuous glucose monitoring' below and "Patient education: Type 1 diabetes: Overview Beyond the Basics ".
Most people with type 1 diabetes who use BGM alone need to check their blood glucose level at least four times every day. If you use an insulin pump, give yourself three or more insulin injections per day, or are currently pregnant, you may need to test as many as 10 times a day or more.
See "Patient education: Care during pregnancy for patients with type 1 or 2 diabetes Beyond the Basics ". This way you will be able to access your testing equipment wherever you are, making it easier to manage your blood glucose.
Glucose monitoring is useful for people with type 2 diabetes who take insulin or certain medications that can cause hypoglycemia. It is generally unnecessary in people who manage their diabetes with diet alone or who take medications that do not cause hypoglycemia, especially if they have reached their glucose goals.
Your health care provider can help you determine how frequently to check your glucose based on your situation. Most people with type 2 diabetes who perform glucose monitoring use BGM. For people taking insulin, CGM may be used if available and affordable. See 'Who should use CGM? How to check your blood glucose — The following steps include general guidelines for testing blood glucose levels.
However, because the instructions can vary between devices, it's best to check the package insert for your glucose meter or talk with your health care provider. It's important to never share monitoring equipment or fingerstick devices, as this could lead to infection. Lancets that are used more than once are not as sharp as a new lancet and can cause more pain and injury to the skin.
Alternate sites are often less painful than the fingertip. However, results from alternate sites are not as accurate as fingertip samples.
This should not be a problem if you always use the same site. However, when your blood glucose is rising rapidly eg, immediately after eating or falling rapidly in response to insulin or exercise , it's more accurate to use the fingertip, as testing at alternate sites may give significantly different results in these situations.
If you have difficulty getting a good drop of blood from your fingertip, try rinsing your fingers with warm water and shaking your hand below your waist. This can help get the blood flowing.
The results will be displayed on the meter after several seconds. Blood glucose meters — There is no single blood glucose meter that is better than others. Your health care provider or pharmacist can help you choose a meter based on your preferences as well as other factors like cost, ease of use, and accuracy; it should be one that is approved by either the International Organization for Standardization or the US Food and Drug Administration FDA.
Medicare also covers costs of BGM. Accuracy of home BGM — Blood glucose meters are reasonably accurate. However, there can be some variability between meters, so it is always wise to use caution and common sense.
If you get a result that does not fit with how you feel for example, if it says your blood glucose is very low but you don't have any symptoms , take a second reading or use an alternate method for testing your blood glucose such as a different meter. Blood glucose meters are least accurate during episodes of low blood glucose.
See "Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics ". The accuracy of BGM can be affected by several factors, including the type of blood glucose strip and meter.
Inaccurate readings can be caused by the use of expired strips, improper storage of strips exposure to high temperature and humidity , inadequate cleansing of your skin, and ingestion of vitamin C and acetaminophen.
It's a good idea to check the accuracy of your blood glucose meter occasionally by bringing it with you when you have an appointment to get blood testing. This way, you use your home monitor to check your blood glucose at the same time that blood is drawn and compare the results.
If the results differ by more than 15 percent, there may be a problem with your meter or other equipment; your provider can help you figure out what's going on and how to correct the problem. Help for people with vision impairment — People with vision impairment a common complication of diabetes sometimes have difficulty using glucose meters.
Meters with large screens and "talking" meters are available. If you have impaired vision, you can get help from the American Association of Diabetes Care and Education Specialists ADCES at Continuous glucose monitoring CGM is a way to monitor your glucose levels every 5 to 15 minutes, 24 hours a day.
Because of reliability issues, warm-up periods, and the need to calibrate some of the devices, CGM does not eliminate the need for at least occasional fingersticks. CGM systems are described in detail above see 'Continuous glucose monitoring' above. Who should use CGM?
CGM systems are most often used by people with type 1 diabetes. Periodic use of CGM can also help you and your health care provider determine when your glucose is low or high and how to adjust your medication doses or food intake to prevent these fluctuations. Devices that combine an insulin pump with a CGM system are also available.
See "Patient education: Type 1 diabetes: Insulin treatment Beyond the Basics ". Advantages — There is evidence that people with type 1 diabetes who use a CGM system consistently and reliably rather than blood glucose monitoring [BGM] have modestly better managed blood glucose levels.
The "real-time" CGM devices automatically display your glucose level every five minutes, using numbers, graphics, and arrows so you can easily tell if your level is increasing, decreasing, or stable figure 3.
The receiver recording device can also be set to trigger an alarm if your glucose level gets above or below a preset level, which can be especially helpful for people who cannot feel when they have low blood glucose also known as "impaired awareness of hypoglycemia".
Most CGM systems permit real-time "sharing" of your CGM readings with others eg, family members or caregivers. Some, but not all, of these intermittently scanning CGM devices are able to alert you of low or high glucose readings.
You can download glucose results from the CGM system to your computer, tablet, or smartphone, allowing you to see glucose trends over time. If you take insulin, your health care provider can help you figure out how to use this information to adjust your insulin dose if needed. Drawbacks — CGM systems may show lower glucose values than blood glucose meters, especially when blood glucose levels are rapidly rising.
In addition, the costs associated with CGM are greater than those of traditional glucose meters. Not all continuous glucose meters and supplies are covered by commercial health insurance companies.
Glucose testing — The results of glucose testing with blood glucose monitoring BGM or continuous glucose monitoring CGM tell you how well your diabetes treatments are working.
Glucose results can be affected by different things, including your level of physical activity, what you eat, stress, and medications including insulin, non-insulin injectable medications, and oral diabetes medications.
To fully understand what your glucose levels mean, it is important to consider all of these factors. When keeping track of your results, you should include the time and date, glucose result, and the medication and dose you are taking.
Additional notes about what you ate, whether you exercised, and any difficulties with illness or stress can also be helpful but are not generally required every day. You should review this information regularly with your health care provider to understand what your results mean and whether you need to make any changes to better manage your glucose levels.
Need for urine testing — If you have type 1 diabetes, your health care provider will talk to you about checking your urine for ketones. Ketones are acids that are formed when the body does not have enough insulin to get glucose into the cells, causing the body to break down fat for energy.
Ketones can also develop during illness, if an inadequate amount of glucose is available due to skipped meals or vomiting.
Enrollment took place from September to Crispy cauliflower tacosand study follow-up for the randomized trial continued Anx December bloood BGM indicates blood snd monitoring; CGM, OMAD and insulin levels glucose monitoring. c Two participants in the standard BGM group initiated real-time CGM before completing the week visit. d One participant in the CGM group and 6 participants in the standard BGM group were missing CGM data at follow-up. Missing data were handled using direct likelihood. Baseline data for these participants were included in the model. To convert glucose values to millimoles per liter, multiply by 0. CGMs continually monitor your glucos glucose blood sugargiving you real-time Hypoglycemia and blood glucose monitors through a device that is attached to your body. They have become popular and Peripheral neuropathy in diabetes accurate over the years and Hypoglycema now OMAD and insulin levels a bloox treatment option for people with diabetes. Advances in Continuous Glucose Monitor CGM technology have made our lives easier, and that goes for people with diabetes as well. Insulin administration and blood glucose blood sugar monitoring have transformed from multiple finger pricks in a day to a few swipes on a cell phone. Real time CGM monitoring has led to tremendous outcomes for people with diabetes who, without a CGM, may have experienced potentially life-threatening complications.
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