Ever since the approval of first CGM by the FDA in 1999, these devices had gained wider acceptance among both health care professionals and patients because of the multiple benefits it provide. A recent study published in ‘The Lancet’ which is an extension of the randomized ALERTT1 trial assessed the effect of switching from intermittently scanned CGM (isCGM) to real time CGM (rtCGM) up to 24 months.

      This 6-month, double-arm, parallel-group, non-masked, randomized, controlled trial, conducted among 254 adults aged 18 years or older with type 1 diabetes previously using isCGM were randomly assigned (1:1) to rtCGM with alerts (intervention; n=127) or isCGM without alerts (control; n=127). After completion of the 6-month trial, the control group switched to rtCGM (is-rtCGM group), and the intervention group continued rtCGM (rt-rtCGM group). The extension focused on within-group changes in time in range, HbA1c, time in clinically significant hypoglycemia, and Hypoglycemia Fear Survey worry (HFS-worry) score. Mean within-group change vs. the start of rtCGM is reported, with a positive value referring to a lower value at start of rtCGM.

      The results revealed that in the rt-rtCGM group, TIR increased from 52·5% at start of rtCGM (month 0) to 63·0% (60·3–65·8) at month 12, also remained stable up to month 24. Similarly HbA1c decreased from 7·4% to 6·9% at month 24 in the is-rtCGM group, and from 7·4% to 7·0% at month 24 in the rt-rtCGM group. The change in HFS-worry score was –2·67 (month 24 vs. month 6; p=0·0008) in the is-rtCGM group and –5·17 points (month 24 vs. month 0; p< 0·0001) in the rt-rtCGM group. Severe hypoglycemia decreased from 31·0 to 3·3 per 100 patient-years after switching to rtCGM. Significant improvements were observed in the glycemic control and hypoglycemia worry after switching from isCGM without alerts to rtCGM with alerts, supporting the use of rtCGM in the care of adults with type 1 diabetes.

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