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Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness

Slide: 19 of 25

Glucose Monitoring With rt-CGM Plus CSII (Sensor-Augmented Pump) Versus MDI Plus SMBG in Children and Adults With Type 1 Diabetes (2 of 2)

Overall diabetes treatment satisfaction was greater in the sensor-augmented pump arm when compared with the MDI/SMBG arm, while there was no significant difference in weight gain between the two arms. The strength of evidence for this finding is rated low.

  • One study reported that at 16 weeks, user acceptance and overall satisfaction was greater among participants in the sensor-augmented pump arm when compared with those in the MDI/SMBG arm. A second study used the Diabetes Treatment Satisfaction Questionnaire to examine disease treatment-related quality of life in 83 CSII-naïve adults with type 1 diabetes. At 26 weeks, satisfaction was greater among participants in the sensor-augmented pump arm when compared with the MDI/SMBG arm.

 The time spent with hyperglycemia was found to be significantly lower in the sensor-augmented pump group versus the MDI/SMBG group. The strength of evidence for this finding was rated moderate.

  • One study assessed the time spent with hyperglycemia and found that in the entire study population, when stratified by age (adults 19 to 70 years of age and children 7 to 18 years of age), those randomized to a sensor-augmented pump had significantly less hyperglycemia when compared with those continuing MDI/SMBG (p < 0.001).
  • A second trial found the percentage of time spent with hyperglycemia was significantly reduced in the sensor-augmented pump group versus the MDI/SMBG group (-17.3%; 95% CI, -25.1 to -9.5%).

Abbreviations: 95% CI = 95-percent confidence interval; CSII = continuous subcutaneous insulin infusion; MDI = multiple daily injections; rt-CGM = real-time continuous glucose monitoring; SMBG = self-monitoring of blood glucose