Young Diabetologist and Endocrinologist Forum Travel Award

Abstract

Aims: The MILLENNIAL randomized crossover study showed that realtime continuous glucose monitoring (RTCGM) improves timeinrange (TIR) and HbA1c in adolescents and young adults with type 1 diabetes compared to selfmonitoring of blood glucose (SMBG). We hypothesized that multiple daily injection (MDI) users can achieve comparable glycaemic outcomes to insulin pump therapy (CSII) users on RTCGM. Methods: Thirty MILLENNIAL participants (16 CSII, 14 MDI) were assigned to RTCGM and SMBG in random order during two 8week study periods. In this subanalysis, changes in HbA1c, TIR, timeaboverange (TAR), timebelowrange (TBR) and mean glucose following RTCGM intervention were compared between CSII and MDI users. Results: HbA1c reduction during RTCGM compared to SMBG period was significant (p < 0.05) and similar (CSII = −5.93 ± 7.71 mmol/mol, MDI = −5.93 ± 8.47 mmol/ mol; p = 0.99) in both groups. TIR during RTCGM was significantly increased compared to SMBG (p < 0.05) among CSII (Δ 11.2 ± 11.0%) and MDI (Δ 11.0 ± 11.3%) users, with no difference between insulin delivery modalities (CSII vs. MDI; p = 0.96). RTCGM intervention led to significant reductions in TAR (CSII = −12.1 ± 11.9%, MDI = −11.7 ± 12.7%; p < 0.05 for both) and mean glucose (CSII = −1.8 ± 1.5 mmol/L, MDI = −1.8 ± 1.9 mmol/L; p < 0.05 for both), which were comparable between both insulin delivery modalities (CSII vs. MDI; TAR p = 0.93, mean glucose p = 0.96). No significant difference in TBR changes between CSII and MDI users (CSII vs. MDI; p = 0.80) was found. Conclusions: Our study has shown that MDI users achieved comparable glycaemic outcomes to CSII users. RTCGM is therefore beneficial in adolescents and young adults with type 1 diabetes, irrespective of insulin delivery modality.