Ketoacidosis Rates Plummet with Continuous Glucose Monitoring Use (ADA2020)

Ketoacidosis Rates Plummet with Continuous Glucose Monitoring Use (ADA2020)


Maintaining their target blood glucose levels as much as possible is critical to preventing various health complications for all people with diabetes. One deadly outcome of high blood glucose levels is diabetic ketoacidosis (DKA), which is a life-threatening emergency, but one that can typically be prevented with optimal glycemic management.

Checking blood glucose levels regularly and making the appropriate medication adjustments to keep in a safe blood glucose range is a challenge for many. Due to various factors, including sometimes a lack of access to a sufficient amount of test strips, patients may not be checking their blood glucose level as frequently as recommended.

Continuous glucose monitoring (CGM) technology is a relatively new development in diabetes care, but has already been shown to benefit many patients as related to glycemic management, mental wellbeing, and overall quality of life. By providing users with almost real-time data of their glucose levels, couples with the ability to set alarms to address blood sugar values that are out of range, prior to developing an emergency situation appears to be a critical tool to help people with diabetes better manage their condition and help safeguard against critical situations like severe hypoglycemia or DKA.

A new study conducted by a team of French researchers has just revealed striking results that underscore the benefits of CGM access for patients. The researchers just presented the major outcomes of the study at the American Diabetes Association (ADA) 80th Scientific Sessions this weekend.

Study Design

The researchers conducted a retrospective analysis of nationwide DKA records for patients with type 1 and type 2 diabetes one year prior to the initiation of the use of the Freestyle Libre system and compared it to the recorded DKA rates one year after the initiation of CGM use in this population. Data from a total of 33,203 patients with type 1 diabetes and 40,955 with type 2 diabetes were included in the study.

Major Outcomes

The differences in the DKA rates before and after CGM use were striking. Overall, the rate of DKA decreased by 52% among those with type 1 diabetes and by 47% among those with type 2 diabetes. Furthermore, the researchers evaluated the impact of CGM technology on patients with different self blood glucose monitoring (fingerstick frequency) habits. The data revealed that the reduction in DKA rate was the most dramatic for those who do not check their blood glucose level daily, as well as for those who check their blood glucose more than five times per day. In fact, the baseline DKA rates were the highest for these two groups. This may seem counterintuitive, but it is likely that patients who check frequently may be doing so because of difficulty in managing their condition.

Roussel et al. (Presented at ADA 2020)

Conclusions

This retrospective analysis of data from a large cohort of patients prior to and after the use of CGM technology suggests that CGM use can help to dramatically decrease the incidence of DKA. The observed improvements in DKA rates were the most pronounced for those who check their blood glucose very little, but also for those who check frequently (more than five times per day). Overall, the study results highlight the potential health benefits of CGM use in preventing DKA in a very large group of patients. Unfortunately, today, access and affordability of CGM systems still remains a challenge for many patients.

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Read more about Abbott FreeStyle Libre, ADA2020, American Diabetes Association (ADA), continuous glucose monitor (CGM), diabetic ketoacidosis (DKA), freestyle, Intensive management, libre, low blood sugar (hypoglycemia).



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