Sustained Intensive Treatment and Long-term Effects on HbA1c Reduction (SILVER Study) by CGM in People With Type 1 Diabetes Treated With MDI
Continuous glucose monitoring (CGM) helps decrease HbA1c and hypoglycemic episodes in people with type 1 diabetes (T1D) treated with multiple daily insulin injections (MDI). There is less knowledge about the extent to which CGM improves and helps to maintain glucose control, diabetes distress, hypoglycemic concerns, treatment satisfaction, and overall well-being over longer periods of time. Hence, Marcus Lind and colleagues conducted a study published in Diabetes Care Journal under the title “Sustained Intensive Treatment and Long-term Effects on HbA1c Reduction (SILVER Study) by CGM in People With Type 1 Diabetes Treated With MDI”. The summary of this study is given below:
Objective:
To evaluate the effects of CGM in adults with T1D managed with MDI.
Method:
The GOLD trial was a randomized crossover trial conducted over 16 months of CGM treatment in people with T1DM treated with MDI. Subjects completing the trial were included in the current SILVER extension study with 107 patients. These patients continued CGM treatment for over 1 year. They were provided with the support of a diabetes nurse every 3 months.
Findings:
The SILVER study supports long-term beneficial effects from CGM. Additionally, this study is in agreement with the suggestion that CGM has independent and sustained effect over time on HbA1c, hypoglycemia, treatment satisfaction, well-being, and hypoglycemic confidence in people with T1D managed with MDI.
While CGM improves HbA1c as well as TIR, most participants are unable to reach targets for the same. Hence, investigators suggest that patients may benefit from extended support with advanced technology systems, including integrated systems, insulin pumps, or hybrid systems.