Notes on the RESCUE Study: Continuous Glucose Monitoring in Type 1 Diabetes

Introduction

Objective: To evaluate the long-term benefits of real-time continuous glucose monitoring (rtCGM) in adults with Type 1 Diabetes using insulin pump therapy, particularly those with impaired awareness of hypoglycemia (IAH).
Background: rtCGM improves glucose control and quality of life but long-term impacts are unclear due to limited long-duration studies.

Study Type: 24-month prospective, observational cohort study.
Participants: 441 adults with insulin pumps receiving rtCGM reimbursement.
- 42% had IAH.
Endpoints:
- Primary: Evolution of HbA1c (a measure of blood glucose control).
- Secondary: Changes in hypoglycemia complications, work absenteeism, quality of life.

HbA1c Levels: Significant reduction from 7.64% (baseline) to 7.37% after 24 months.
Hypoglycemia-related Benefits:
- Reduction in fear of hypoglycemia and acute hypoglycemic events.
- Strongest improvements in individuals with IAH.
- Severe hypoglycemia events significantly decreased.
Work Absenteeism: Reduced diabetes-related days off from work.
Quality of Life: Improvements sustained over 24 months; significant reduction in hypoglycemia-related worries.

Long-term Impact: rtCGM use leads to sustained improvements in glucose control and quality of life.
Implications for IAH: Significant benefits observed in patients with impaired awareness of hypoglycemia.
Overall Benefits: Lower hypoglycemia risk, improved quality of life, reduced work absenteeism.

Duration: Conducted from September 2014 to March 2019.
Ethics: Compliant with the Declaration of Helsinki and approved by institutional review boards.

Data drop-out from four centers reduced participant number from initial 515 to 441.
Non-randomized design; other motivational factors may have influenced results.

Studies and trials on continuous glucose monitoring and its effects on glycemic control and hypoglycemia awareness.