Diabetes Mellitus Type 1 Clinical Trial
Official title:
Long-term Effects of Continuous Glucose Monitoring in Patients With Type 1 Diabetes Treated With Multiple Daily Insulin Injections - Extension of CGMMDI Trial
A keystone in preventing diabetic complications in patients with type 1 diabetes is good
glycaemic control. Frequent self-measurements of blood glucose (SMBG) levels have been an
essential part of insulin dosing before meals. However, in recent years continuous glucose
monitoring (CGM) has become a treatment option to inform the patient when glucose levels may
be too high or low.
In some countries, including Sweden, CGM is reimbursed only when combined with continuous
subcutaneous insulin infusions (CSII) in patients with very poor glycaemic control or a
history of repeated severe hypoglycaemia in adults with type 1 diabetes. This is based on
existing clinical trial data showing a beneficial effect on HbA1c when CGM is combined with
CSII. However, despite the fact that the majority of adults with type 1 diabetes are treated
with multiple daily insulin injections (MDI), studies on the effect of CGM in patients with
type 1 diabetes treated with MDI are sparse. Therefore, the investigators initiated the
CGMMDI trial, an ongoing, cross-over clinical trial including 161 MDI patients receiving CGM
over 6 months, followed by conventional therapy over six months, with a four-month wash-out
period in-between treatment. Evaluations include glycaemic control, hypoglycaemia, quality of
life, fear of hypoglycaemia, treatment satisfaction, physical activity, and safety.
From a research or regulatory standpoint, long-term data on treatment effects are expected to
a greater extent today than in previous years, due to various reasons, e.g., to evaluate any
sustained beneficial effects over time, or long-term patient safety. Accordingly, follow-up
of treatment in an extension phase after randomized diabetes trials have become more common
over time, especially where many novel glucose-lowering treatments are concerned. Therefore,
the aim of the current study is to evaluate long-term effects of CGM in patients with type 1
diabetes treated with MDI. Patients who consent in an extension phase over 1 year of the
CGMMDI trial will receive CGM, and evaluations will be performed on sustained glycaemic
control effects, hypoglycaemia, glycaemic variability, quality of life, fear of
hypoglycaemia, treatment satisfaction, physical activity, and safety.
n/a
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