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Continuous glucose monitoring in adults with type 1 diabetes with 35 years duration from the DCCT/EDIC study

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Gubitosi-Klug, Rose A., Braffett, Barbara H., Bebu, Ionut, Johnson, Mary L., Farrell, Kaleigh, Kenny, David, Trapani, Victoria R., Meadema-Mayer, Lynne +5 more·2022·Diabetes Care
DOI 10.2337/dc21-0629PMC PMC8918229

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Abstract

Objective We evaluated blinded continuous glucose monitoring (CGM) profiles in a subset of adults with type 1 diabetes from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study to characterize the frequency of glycemic excursions and contributing factors. Research design and methods CGM-derived metrics were compared for daytime and nighttime periods using blinded CGM for a minimum of 6.5 days (average 11.9 days) and correlated with HbA1c levels, routine use of diabetes devices, and other characteristics in 765 participants. Results Participants were 58.9 ± 6.5 years of age with diabetes duration 36.8 ± 4.9 years and HbA1c 7.8 ± 1.2%; 58% used insulin pumps, and 27% used personal, unblinded CGM. Compared with daytime, nighttime mean sensor glucose was lower, percent time in range 70-180 mg/dL (TIR) was similar, and hypoglycemia was more common. Over the entire recording period, only 9% of the 765 participants achieved >70% TIR and only 28% achieved Conclusions In adults with long-standing type 1 diabetes, short-term blinded CGM profiles revealed frequent clinically significant hypoglycemia (<54 mg/dL) during the night and more time in hyperglycemia during the day. The small subset of participants using routine CGM and insulin pumps had fewer hypoglycemic and hyperglycemic excursions and lower HbA1c levels. Thus, strategies to lower meal-stimulated hyperglycemia during the day and prevent hypoglycemia at night a…

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  • Observational data from the DCCT/EDIC study indicate that among older adults (mean age 58 years) with long-standing type 1 diabetes, routine continuous glucose monitoring and insulin pump use was associated with fewer hypoglycemic events and hyperglycemic excursions and lower A1C levels.

    “These and other short-term trials are supported by observational data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study indicating that among older adults (mean age 58 years) with long-standing type 1 diabetes, routine CGM and insulin pump use was associated with fewer hypoglycemic events and hyperglycemic excursions and”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [41]

  • Observational data from the DCCT/EDIC study indicate that among older adults (mean age 58 years) with long-standing type 1 diabetes, routine CGM and insulin pump use was associated with fewer hypoglycemic events and hyperglycemic excursions and lower A1C levels.

    “These and other short-term trials are supported by observational data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study indicating that among older adults (mean age 58 years) with long-standing type 1 diabetes, routine CGM and insulin pump use was associated with fewer hypoglycemic events and hyperglycemic excursions and”

    From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [43]

  • CGM devices have been shown to be effective at improving glycemic management.

    “Continuous glucose monitoring (CGM) devices have been shown to be effective at improving glycemic management and acceptable to people of all age-groups, including older individuals with type 1 diabetes (44–48) or insulin-requiring type 2 diabetes (49,50).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [47]

  • CGM devices are acceptable to people of all age-groups, including older individuals with type 1 diabetes or insulin-requiring type 2 diabetes.

    “Continuous glucose monitoring (CGM) devices have been shown to be effective at improving glycemic management and acceptable to people of all age-groups, including older individuals with type 1 diabetes (44–48) or insulin-requiring type 2 diabetes (49,50).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [47]

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Authors
Gubitosi-Klug, R. A., Braffett, B. H., Bebu, I., Johnson, M. L., Farrell, K., Kenny, D., Trapani, V. R., Meadema-Mayer, L., Soliman, E. Z., Pop-Busui, R., Lachin, J. M., Bergenstal, R. M., & Tamborlane, W. V.
Affiliations
  • Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH
  • George Washington University (US)
  • International Diabetes Center, Minneapolis, MN
  • Rainbow Babies & Children's Hospital (US)
  • Wake Forest University Health Sciences (US)
  • University of Michigan, Ann Arbor, MI
  • Yale University (US)
Corresponding author
Braffett, Barbara H.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2022-01-25
Volume
45
Issue
3
Pages
659-665
ISSN
0149-5992 (ISSN-L)
DOI
10.2337/dc21-0629
PMC
PMC8918229
OpenAlex
W4207049476
Cited by
31
References
10
Citations by year
2026: 2 · 2025: 9 · 2024: 8 · 2023: 6 · 2022: 6
FWCI
5.37
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/content/license (vor)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5u01dk094157-13, UL1TR001863)
  • National Institute of Diabetes and Digestive and Kidney Diseases (U01DK094176, U01-DK094157, DP3DK106890, P30DK020572, P30DK045735)
  • National Center for Advancing Translational Sciences
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
type 1 diabetes, continuous glucose monitoring, glycemic excursions, hypoglycemia, hyperglycemia, time in range, HbA1c, insulin pump, long-standing diabetes, adults
MeSH terms
Adult, Aged, Blood Glucose, Diabetes Mellitus, Type 1, Glucose, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Blood Glucose Self-Monitoring

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