CoChat
Sign Up
Cited by 494Diabetes Management and ResearchDiabetes Management and EducationDiabetes Treatment and Management

The use and efficacy of continuous glucose monitoring in type 1 diabetes treated with insulin pump therapy: a randomised controlled trial

Open access
the SWITCH Study Group, Battelino, T., Conget, I., Olsen, B., Schütz-Fuhrmann, I., Hommel, E., Hoogma, R., Schierloh, U. +2 more·2012·Diabetologia
DOI 10.1007/s00125-012-2708-9PMC PMC3483098
Open this paper in CoChat — free accountOpen PDF

Abstract

AIMS/HYPOTHESIS: The aim of this multicentre, randomised, controlled crossover study was to determine the efficacy of adding continuous glucose monitoring (CGM) to insulin pump therapy (CSII) in type 1 diabetes. METHODS: Children and adults (n = 153) on CSII with HbA(1c) 7.5-9.5% (58.5-80.3 mmol/mol) were randomised to (CGM) a Sensor On or Sensor Off arm for 6 months. After 4 months' washout, participants crossed over to the other arm for 6 months. Paediatric and adult participants were separately electronically randomised through the case report form according to a predefined randomisation sequence in eight secondary and tertiary centres. The primary outcome was the difference in HbA(1c) levels between arms after 6 months. RESULTS: Seventy-seven participants were randomised to the On/Off sequence and 76 to the Off/On sequence; all were included in the primary analysis. The mean difference in HbA(1c) was -0.43% (-4.74 mmol/mol) in favour of the Sensor On arm (8.04% [64.34 mmol/mol] vs 8.47% [69.08 mmol/mol]; 95% CI -0.32%, -0.55% [-3.50, -6.01 mmol/mol]; p < 0.001). Following cessation of glucose sensing, HbA(1c) reverted to baseline levels. Less time was spent with sensor glucose <3.9 mmol/l during the Sensor On arm than in the Sensor Off arm (19 vs 31 min/day; p = 0.009). The mean number of daily boluses increased in the Sensor On arm (6.8 ± 2.5 vs 5.8 ± 1.9, p < 0.0001), together with the frequency of use of the temporary basal rate (0.75 ± 1.11 vs 0.26 ± 0.47, p < 0.0001) and manual insulin suspend (0.91 ± 1.25 vs 0.70 ± 0.75, p < 0.018) functions. Four vs two events of severe hypoglycaemia occurred in the Sensor On and Sensor Off arm, respectively (p = 0.40). CONCLUSIONS/INTERPRETATION: Continuous glucose monitoring was associated with decreased HbA(1c) levels and time spent in hypoglycaemia in individuals with type 1 diabetes using CSII. More frequent self-adjustments of insulin therapy may have contributed to these effects.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s00125-012-2708-9

Cites

22 of 22 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A1C is currently recognized as the key surrogate marker for the development of long-term diabetes complications in people with type 1 and type 2 diabetes.

    “A1C is currently recognized as the key surrogate marker for the development of longterm diabetes complications in people with type 1 and type 2 diabetes and has been used the primary endpoint for many CGM studies (1; 3; 4; 6; 32; 33).”

    From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [33]

    The Introduction (page unavailable) links near-normal glycaemia with reduced complication risk in type 1 diabetes, and Methods > Outcome measure (page unavailable) uses HbA1c as this trial’s primary endpoint. The paper does not establish HbA1c as the key surrogate marker for long-term complications in both type 1 and type 2 diabetes. (LLM, conf=0.81)

    Experimental — accuracy not yet measured

  • A1C has been used as the primary endpoint for many CGM studies.

    “A1C is currently recognized as the key surrogate marker for the development of longterm diabetes complications in people with type 1 and type 2 diabetes and has been used the primary endpoint for many CGM studies (1; 3; 4; 6; 32; 33).”

    From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [33]

    The Methods > Outcome measure section identifies HbA1c as the primary endpoint of this CGM trial. The Discussion discusses HbA1c results from other CGM trials, but does not establish that it was the primary endpoint in many of them. The cited paper therefore supports an example of the claimed practice, not its stated frequency. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Reductions in HbA1c have been reported with CGM use in people on MDI therapy and continuous subcutaneous insulin infusion therapy, with reduced time spent in hypoglycemia and improved hypoglycemia awareness.

    “Reductions in HbA1c have been reported with CGM use in people on multiple daily injection (MDI) therapy,19 and continuous subcutaneous insulin infusion therapy,20 with reduced time spent in hypoglycemia,20 and improved hypoglycemia awareness.21”

    From Increased Time in Range and Fewer Missed Bolus Injections After Introduction of a Smart Connected Insulin Pen (2020) · cites this paper as [20]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
the SWITCH Study Group, Battelino, T., Conget, I., Olsen, B., Schütz-Fuhrmann, I., Hommel, E., Hoogma, R., Schierloh, U., Sulli, N., & Bolinder, J.
Affiliations
  • University of Ljubljana (SI)
  • Glostrup Hospital (DK)
  • Klinik Hietzing (AT)
  • Groene Hart Ziekenhuis (NL)
  • Centre Hospitalier de Luxembourg (LU)
  • Karolinska University Hospital (SE)
Corresponding author
Battelino, T.
ORCID
Venue
Diabetologia
Publisher
Springer Science and Business Media LLC
Published
2012-09-11
Volume
55
Issue
12
Pages
3155-3162
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
DOI
10.1007/s00125-012-2708-9
PMC
PMC3483098
OpenAlex
W2075474575
Cited by
494
References
22
Citations by year
2026: 14 · 2025: 20 · 2024: 28 · 2023: 27 · 2022: 27 · 2021: 52 · 2020: 52 · 2019: 52 · 2018: 53 · 2017: 44 · 2016: 39 · 2015: 28 · 2014: 30 · 2013: 25 · 2012: 1
FWCI
21.56
Type
journal article
Language
en
Open access
Licence
cc-by-nc
Locations
  • Diabetologia (publishedVersion, cc-by-nc)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Open Repository and Bibliography (University of Luxembourg) (submittedVersion, cc-by-nc-sa)
  • IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
continuous glucose monitoring, type 1 diabetes, insulin pump therapy, artificial pancreas, HbA1c, glycemic control, hypoglycemia, bolus insulin, children and adults, crossover trial, cost-effectiveness, quality of life
MeSH terms
Adolescent, Adult, Aged, Blood Glucose, Child, Diabetes Mellitus, Type 1, Female, Humans, Hyperglycemia, Hypoglycemic Agents, Insulin, Insulin Infusion Systems, Male, Middle Aged, Monitoring, Physiologic, Blood Glucose Self-Monitoring, Biosensing Techniques, Treatment Outcome, Cross-Over Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review