Hi-R-Ed Online

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JDRF Study: Near Daily Use of CGM Associated With Significant Decrease in A1c

The JDRF Study evaluated the management of type 1 diabetes.

JDRF Continuous Glucose Monitoring Study Group. N Engl J Med. 2008;359(14):1464-1476.

The topline conclusions were the following:

Near daily use of a CGM is associated with a significant decrease in A1c

The use of continuous monitoring was greater in the patients aged 25 years or older

Baseline to 26 weeks: mean difference of minus 0.53% (CI -0.71 to -0.35; P<.001) in patients 25 years or older

Near daily use of CGM associated with similar benefit in A1c for all age groups

Hypoglycemia did not increase even in the adult group with lower A1c

JDRF CGM Study Group

26-Week A1c reduction (≥7.0% Cohort)

The landmark JDRF CGM study published in the New England Journal of Medicine in 2008 was done with earlier generations of CGM devices.

The results are well-known: adults achieved a statistically significant 0.5% decrease in A1c whereas the adolescents and children did not. However, this was not due to the benefits of CGM use, but rather in the frequency of their use.

Teen Strife? No. Frequency/Regularity of CGM Use

A year later, further analysis of the study was published and showed that the problem wasn’t something intrinsic to adolescents and children (although there are problems intrinsic to those age groups, as any parent knows) but had to do with the amount of time patients used the device.

Of significance, all patients (young and old) who used their CGM devices at least 6 days/week on average achieved a statistically significant reduction in A1c.

JDRF CGM Study Group (A1c <7.0% Cohort)

Less time in hypoglycemia

In looking at the chart below you can see what is the most striking information gleaned from this study: the reduction in time spent in hypoglycemic range. We can see here that use of CGM greatly reduces incidence and severity of hypoglycemia over SMBG during 26 week period.