Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness
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
- Golden SH, Brown T, Yeh HC, et al. Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness. Comparative Effectiveness Review No. 57 (Prepared by the Johns Hopkins University Evidence-based Practice Center under Contract No. 290-2007-10061-I). Rockville, MD: Agency for Healthcare Research and Quality; July 2012. AHRQ Publication No. 12-EHC036. Available at www.effectivehealthcare.ahrq.gov/glucose.cfm.
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