The effect of short-term use of the Guardian RT continuous glucose monitoring system on fear of hypoglycaemia in patients with type 1 diabetes mellitus

摘要

Aim: This study examines whether the short-term use of a continuous glucose monitor (CGM) can reduce the fear of hypoglycaemia in individuals with type 1 diabetes mellitus (T1DM). Methods: Twelve participants with T1DM were fitted with a Guardian? REAL-Time CGM and assigned to either an alarm (low glucose alarm set at 4.5 mmol/L) or no alarm condition for 3 days, with both treatments administered following a counterbalanced study design. The participants completed the Hypoglycaemia Fear Survey on three separate occasions, before their CGM was fitted as well as following the alarm and no alarm conditions. Results: The alarm treatment reduced the incidence of hypoglycaemic episodes (CGM readings ≤ 3.5 mmol/L; 1.1 ± 0.5 versus 1.9 ± 0.5; mean ± SEM) and the relative time spent below this hypoglycaemic threshold (0.9 ± 0.4% versus 2.6 ± 1.0%) but did not alter the fear of hypoglycaemia (78.6 ± 7.0, 75.8 ± 5.2 and 79.3 ± 5.8 at baseline and following the alarm and no alarm treatments, respectively; p > 0.05). CGM overestimated blood glucose levels by 0.8 ± 0.2 mmol/L for blood glucose readings less than, or equal to, 5 mmol/L. Conclusions: Short-term use of the Guardian? REAL-Time CGM has no clinically significant effect on fear of hypoglycaemia possibly due, in part, to the inaccuracies of CGMs at low blood glucose levels.