Effect of Continuous Glucose Monitoring on Glycemic Control in Patients With Type 2 Diabetes Treated With Basal Insulin

作者：Thomas W. Martens, Roy W. Beck, Ryan Bailey, Katrina J. Ruedy, Peter Calhoun, Anne L. Peters, Rodica Pop‐Busui, Athena Philis‐Tsimikas, Shichun Bao, Guillermo E. Umpierrez, Georgia M. Davis, Davida Kruger, Anuj Bhargava, Laura Young, Janet B. McGill, Grazia Aleppo, Quang T. Nguyen, Ian J. Orozco, William Biggs, K. Lucas, William H. Polonsky, John B. Buse, David A. Price, Richard M. Bergenstal, MOBILE Study Group, Anders L. Carlson, Sharon Chambers, Shoua Yang, M. Sue Kirkman, Alexander Kass, Rachael Fraser, Terra Cushman, Clementina Ramos, Maria Magar, Martha Walker, Sara Serafin-Dokhan, Maamoun Salam, Stacy Hurst, Mary Jane Clifton, Jelena Kravarusic, Anupam Bansal, Candice Fulkerson, Lynn Ang, Caroline R. Richardson, Kara Mizokami‐Stout, Jake Reiss, Virginia Leone, Kirstie Stifel, George Dailey, Amy Change, James McCallum, María Isabel Ávalos García, Dianne Davis, C. Lovell, Connie Root, Freida Toler, Lori Wilhelm, Robin Eifert, Lorena Murguia, Becky Cota, Loida Nguyen, Randie Lipski, Mary Katherine Lawrence, Adelle Fournier, Matthew Carter, Stephanie Hoover, Nathan Cohen, Thomas J. Mouse, Jessica Rusnak, Tiffany Campos, Nelly M. Njeru, Tom Arant, Stayce E. Beck, Andrew K. Balo · 发表于：JAMA · 年份：2021 · DOI：10.1001/jama.2021.7444 · 被引用次数：528 · 研究领域：Diabetes Management and Research、Hyperglycemia and glycemic control in critically ill and hospitalized patients、Diabetes Treatment and Management

Importance: Continuous glucose monitoring (CGM) has been shown to be beneficial for adults with type 2 diabetes using intensive insulin therapy, but its use in type 2 diabetes treated with basal insulin without prandial insulin has not been well studied. Objective: To determine the effectiveness of CGM in adults with type 2 diabetes treated with basal insulin without prandial insulin in primary care practices. Design, Setting, and Participants: This randomized clinical trial was conducted at 15 centers in the US (enrollment from July 30, 2018, to October 30, 2019; follow-up completed July 7, 2020) and included adults with type 2 diabetes receiving their diabetes care from a primary care clinician and treated with 1 or 2 daily injections of long- or intermediate-acting basal insulin without prandial insulin, with or without noninsulin glucose-lowering medications. Interventions: Random assignment 2:1 to CGM (n = 116) or traditional blood glucose meter (BGM) monitoring (n = 59). Main Outcomes and Measures: The primary outcome was hemoglobin A1c (HbA1c) level at 8 months. Key secondary outcomes were CGM-measured time in target glucose range of 70 to 180 mg/dL, time with glucose level at greater than 250 mg/dL, and mean glucose level at 8 months. Results: Among 175 randomized participants (mean [SD] age, 57 [9] years; 88 women [50%]; 92 racial/ethnic minority individuals [53%]; mean [SD] baseline HbA1c level, 9.1% [0.9%]), 165 (94%) completed the trial. Mean HbA1c level decreased...