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Assessing non‐adjunctive CGM safety at home and in new markets (ANSHIN)
Introduction Continuous glucose monitoring (CGM) can guide treatment for people with type 1 (T1D) and type 2 diabetes (T2D). The ANSHIN study assessed the impact of non‐adjunctive CGM use in adults with diabetes using intensive insulin therapy (IIT). Materials and Methods This single‐arm, prospectiv...
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Published in: | Endocrinology, diabetes & metabolism diabetes & metabolism, 2023-05, Vol.6 (3), p.e414-n/a |
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description | Introduction
Continuous glucose monitoring (CGM) can guide treatment for people with type 1 (T1D) and type 2 diabetes (T2D). The ANSHIN study assessed the impact of non‐adjunctive CGM use in adults with diabetes using intensive insulin therapy (IIT).
Materials and Methods
This single‐arm, prospective, interventional study enrolled adults with T1D or T2D who had not used CGM in the prior 6 months. Participants wore blinded CGMs (Dexcom G6) during a 20‐day run‐in phase, with treatment based on fingerstick glucose values, followed by a 16‐week intervention phase and then a randomized 12‐week extension phase with treatment based on CGM values. The primary outcome was change in HbA1c. Secondary outcomes were CGM metrics. Safety endpoints were the number of severe hypoglycaemic (SH) and diabetic ketoacidosis (DKA) events.
Results
Of the 77 adults enrolled, 63 completed the study. Those enrolled had mean (SD) baseline HbA1c of 9.8% (1.9%), 36% had T1D, and 44% were ≥65 years old. Mean HbA1c decreased by 1.3, 1.0 and 1.0 percentage points for participants with T1D, T2D or age ≥65, respectively (p |
doi_str_mv | 10.1002/edm2.414 |
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Continuous glucose monitoring (CGM) can guide treatment for people with type 1 (T1D) and type 2 diabetes (T2D). The ANSHIN study assessed the impact of non‐adjunctive CGM use in adults with diabetes using intensive insulin therapy (IIT).
Materials and Methods
This single‐arm, prospective, interventional study enrolled adults with T1D or T2D who had not used CGM in the prior 6 months. Participants wore blinded CGMs (Dexcom G6) during a 20‐day run‐in phase, with treatment based on fingerstick glucose values, followed by a 16‐week intervention phase and then a randomized 12‐week extension phase with treatment based on CGM values. The primary outcome was change in HbA1c. Secondary outcomes were CGM metrics. Safety endpoints were the number of severe hypoglycaemic (SH) and diabetic ketoacidosis (DKA) events.
Results
Of the 77 adults enrolled, 63 completed the study. Those enrolled had mean (SD) baseline HbA1c of 9.8% (1.9%), 36% had T1D, and 44% were ≥65 years old. Mean HbA1c decreased by 1.3, 1.0 and 1.0 percentage points for participants with T1D, T2D or age ≥65, respectively (p < .001 for each). CGM‐based metrics including time in range also improved significantly. SH events decreased from the run‐in period (67.3 per 100 person‐years) to the intervention period (17.0 per 100 person‐years). Three DKA events unrelated to CGM use occurred during the total intervention period.
Conclusions
Non‐adjunctive use of the Dexcom G6 CGM system improved glycaemic control and was safe for adults using IIT.
ANSHIN is a single‐arm, prospective, interventional study that assessed the impact of non‐adjunctive Dexcom G6 continuous glucose monitoring (CGM) in adults with diabetes using intensive insulin therapy. After initiating CGM use, severe hypoglycemic events decreased and mean HbA1c decreased by 1.3, 1.0, and 1.0 percentage points for participants with type 1 diabetes (T1D), type 2 diabetes (T2D), or age ≥65, respectively (p<.001 for each) after 16 weeks. Non‐adjunctive use of CGM improved glycemic control and may help those with T1D or T2D make safe treatment decisions.</description><identifier>ISSN: 2398-9238</identifier><identifier>EISSN: 2398-9238</identifier><identifier>DOI: 10.1002/edm2.414</identifier><identifier>PMID: 36864014</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>Accuracy ; Adult ; Aged ; Algorithms ; Blood Glucose ; Blood Glucose Self-Monitoring ; Diabetes ; Diabetes Mellitus, Type 1 - drug therapy ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetic Ketoacidosis ; Enrollments ; FDA approval ; Glucose monitoring ; glycaemic control ; glycated haemoglobin ; Glycated Hemoglobin ; Humans ; Hypoglycemia ; Hypoglycemic Agents - adverse effects ; Infusion pumps ; Insulin ; Insulin, Regular, Human ; Older people ; Prospective Studies</subject><ispartof>Endocrinology, diabetes & metabolism, 2023-05, Vol.6 (3), p.e414-n/a</ispartof><rights>2023 The Authors. published by John Wiley & Sons Ltd.</rights><rights>2023 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.</rights><rights>2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4664-ce888ea7a71f22aa82306b741d439a5796cc1201eca27b64f9eda2188f1e12443</cites><orcidid>0000-0003-4646-433X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2810380838/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2810380838?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11562,25753,27924,27925,37012,37013,44590,46052,46476,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36864014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chao, Christy</creatorcontrib><creatorcontrib>Andrade, Sarah B.</creatorcontrib><creatorcontrib>Bergford, Simon</creatorcontrib><creatorcontrib>Calhoun, Peter</creatorcontrib><creatorcontrib>Welsh, John B.</creatorcontrib><creatorcontrib>Walker, Tomas C.</creatorcontrib><creatorcontrib>ANSHIN Study Group</creatorcontrib><creatorcontrib>ANSHIN Study Group</creatorcontrib><title>Assessing non‐adjunctive CGM safety at home and in new markets (ANSHIN)</title><title>Endocrinology, diabetes & metabolism</title><addtitle>Endocrinol Diabetes Metab</addtitle><description>Introduction
Continuous glucose monitoring (CGM) can guide treatment for people with type 1 (T1D) and type 2 diabetes (T2D). The ANSHIN study assessed the impact of non‐adjunctive CGM use in adults with diabetes using intensive insulin therapy (IIT).
Materials and Methods
This single‐arm, prospective, interventional study enrolled adults with T1D or T2D who had not used CGM in the prior 6 months. Participants wore blinded CGMs (Dexcom G6) during a 20‐day run‐in phase, with treatment based on fingerstick glucose values, followed by a 16‐week intervention phase and then a randomized 12‐week extension phase with treatment based on CGM values. The primary outcome was change in HbA1c. Secondary outcomes were CGM metrics. Safety endpoints were the number of severe hypoglycaemic (SH) and diabetic ketoacidosis (DKA) events.
Results
Of the 77 adults enrolled, 63 completed the study. Those enrolled had mean (SD) baseline HbA1c of 9.8% (1.9%), 36% had T1D, and 44% were ≥65 years old. Mean HbA1c decreased by 1.3, 1.0 and 1.0 percentage points for participants with T1D, T2D or age ≥65, respectively (p < .001 for each). CGM‐based metrics including time in range also improved significantly. SH events decreased from the run‐in period (67.3 per 100 person‐years) to the intervention period (17.0 per 100 person‐years). Three DKA events unrelated to CGM use occurred during the total intervention period.
Conclusions
Non‐adjunctive use of the Dexcom G6 CGM system improved glycaemic control and was safe for adults using IIT.
ANSHIN is a single‐arm, prospective, interventional study that assessed the impact of non‐adjunctive Dexcom G6 continuous glucose monitoring (CGM) in adults with diabetes using intensive insulin therapy. After initiating CGM use, severe hypoglycemic events decreased and mean HbA1c decreased by 1.3, 1.0, and 1.0 percentage points for participants with type 1 diabetes (T1D), type 2 diabetes (T2D), or age ≥65, respectively (p<.001 for each) after 16 weeks. Non‐adjunctive use of CGM improved glycemic control and may help those with T1D or T2D make safe treatment decisions.</description><subject>Accuracy</subject><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Blood Glucose</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetic Ketoacidosis</subject><subject>Enrollments</subject><subject>FDA approval</subject><subject>Glucose monitoring</subject><subject>glycaemic control</subject><subject>glycated haemoglobin</subject><subject>Glycated Hemoglobin</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Infusion pumps</subject><subject>Insulin</subject><subject>Insulin, Regular, Human</subject><subject>Older people</subject><subject>Prospective Studies</subject><issn>2398-9238</issn><issn>2398-9238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kc1uEzEURkcIRKtSiSdAltiUxRRfj-OfFYpCaSO1ZQGsrRvPnXTCxC7jmVbZ8Qg8I0-CQ0ppkVjZso-OP9-vKF4CPwbOxVuq1-JYgnxS7IvKmtKKyjx9sN8rDlNacc7BWqu4eF7sVcooyUHuF_NpSpRSG5YsxPDz-w-sV2PwQ3tDbHZ6wRI2NGwYDuwqrolhqFkbWKBbtsb-Kw2JHU0vP53NL9-8KJ412CU6vFsPii8fTj7Pzsrzj6fz2fS89FIpWXoyxhBq1NAIgWhExdVCS6hlZXGirfIeBAfyKPRCycZSjQKMaYBASFkdFPOdt464ctd9m4NsXMTW_T6I_dJhP7S-I4d80hjNF7rO48lPokKhJIASXE9qstn1bue6Hhdrqj2FocfukfTxTWiv3DLeOOCgchaeDUd3hj5-GykNbt0mT12HgeKYnNCmklYLEBl9_Q-6imMf8qycMMArw01l_gp9H1PqqblPA9xt-3bbvl3-UEZfPUx_D_5pNwPlDrhtO9r8V-RO3l-IrfAXAoOxaw</recordid><startdate>202305</startdate><enddate>202305</enddate><creator>Chao, Christy</creator><creator>Andrade, Sarah B.</creator><creator>Bergford, Simon</creator><creator>Calhoun, Peter</creator><creator>Welsh, John B.</creator><creator>Walker, Tomas C.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-4646-433X</orcidid></search><sort><creationdate>202305</creationdate><title>Assessing non‐adjunctive CGM safety at home and in new markets (ANSHIN)</title><author>Chao, Christy ; Andrade, Sarah B. ; Bergford, Simon ; Calhoun, Peter ; Welsh, John B. ; Walker, Tomas C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4664-ce888ea7a71f22aa82306b741d439a5796cc1201eca27b64f9eda2188f1e12443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accuracy</topic><topic>Adult</topic><topic>Aged</topic><topic>Algorithms</topic><topic>Blood Glucose</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetic Ketoacidosis</topic><topic>Enrollments</topic><topic>FDA approval</topic><topic>Glucose monitoring</topic><topic>glycaemic control</topic><topic>glycated haemoglobin</topic><topic>Glycated Hemoglobin</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Infusion pumps</topic><topic>Insulin</topic><topic>Insulin, Regular, Human</topic><topic>Older people</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chao, Christy</creatorcontrib><creatorcontrib>Andrade, Sarah B.</creatorcontrib><creatorcontrib>Bergford, Simon</creatorcontrib><creatorcontrib>Calhoun, Peter</creatorcontrib><creatorcontrib>Welsh, John B.</creatorcontrib><creatorcontrib>Walker, Tomas C.</creatorcontrib><creatorcontrib>ANSHIN Study Group</creatorcontrib><creatorcontrib>ANSHIN Study Group</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Endocrinology, diabetes & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chao, Christy</au><au>Andrade, Sarah B.</au><au>Bergford, Simon</au><au>Calhoun, Peter</au><au>Welsh, John B.</au><au>Walker, Tomas C.</au><aucorp>ANSHIN Study Group</aucorp><aucorp>ANSHIN Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessing non‐adjunctive CGM safety at home and in new markets (ANSHIN)</atitle><jtitle>Endocrinology, diabetes & metabolism</jtitle><addtitle>Endocrinol Diabetes Metab</addtitle><date>2023-05</date><risdate>2023</risdate><volume>6</volume><issue>3</issue><spage>e414</spage><epage>n/a</epage><pages>e414-n/a</pages><issn>2398-9238</issn><eissn>2398-9238</eissn><abstract>Introduction
Continuous glucose monitoring (CGM) can guide treatment for people with type 1 (T1D) and type 2 diabetes (T2D). The ANSHIN study assessed the impact of non‐adjunctive CGM use in adults with diabetes using intensive insulin therapy (IIT).
Materials and Methods
This single‐arm, prospective, interventional study enrolled adults with T1D or T2D who had not used CGM in the prior 6 months. Participants wore blinded CGMs (Dexcom G6) during a 20‐day run‐in phase, with treatment based on fingerstick glucose values, followed by a 16‐week intervention phase and then a randomized 12‐week extension phase with treatment based on CGM values. The primary outcome was change in HbA1c. Secondary outcomes were CGM metrics. Safety endpoints were the number of severe hypoglycaemic (SH) and diabetic ketoacidosis (DKA) events.
Results
Of the 77 adults enrolled, 63 completed the study. Those enrolled had mean (SD) baseline HbA1c of 9.8% (1.9%), 36% had T1D, and 44% were ≥65 years old. Mean HbA1c decreased by 1.3, 1.0 and 1.0 percentage points for participants with T1D, T2D or age ≥65, respectively (p < .001 for each). CGM‐based metrics including time in range also improved significantly. SH events decreased from the run‐in period (67.3 per 100 person‐years) to the intervention period (17.0 per 100 person‐years). Three DKA events unrelated to CGM use occurred during the total intervention period.
Conclusions
Non‐adjunctive use of the Dexcom G6 CGM system improved glycaemic control and was safe for adults using IIT.
ANSHIN is a single‐arm, prospective, interventional study that assessed the impact of non‐adjunctive Dexcom G6 continuous glucose monitoring (CGM) in adults with diabetes using intensive insulin therapy. After initiating CGM use, severe hypoglycemic events decreased and mean HbA1c decreased by 1.3, 1.0, and 1.0 percentage points for participants with type 1 diabetes (T1D), type 2 diabetes (T2D), or age ≥65, respectively (p<.001 for each) after 16 weeks. Non‐adjunctive use of CGM improved glycemic control and may help those with T1D or T2D make safe treatment decisions.</abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>36864014</pmid><doi>10.1002/edm2.414</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4646-433X</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Accuracy Adult Aged Algorithms Blood Glucose Blood Glucose Self-Monitoring Diabetes Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 2 - drug therapy Diabetic Ketoacidosis Enrollments FDA approval Glucose monitoring glycaemic control glycated haemoglobin Glycated Hemoglobin Humans Hypoglycemia Hypoglycemic Agents - adverse effects Infusion pumps Insulin Insulin, Regular, Human Older people Prospective Studies |
title | Assessing non‐adjunctive CGM safety at home and in new markets (ANSHIN) |
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