International Journal of Medical Advances and Discoveries

International Scholars Journal of Medical Advances and Discoveries | Vol. 16, No. 5, May 2025 | pp. 25–32

DOI: 10.46882/2025/IJMAD/000104

Original Research Article

Title: Impact of Continuous Glucose Monitoring on Glycemic Variability and Hypoglycemia in Type 1 Diabetes Mellitus

Names of Authors: O. P. Chen¹, Q. R. Johansson², S. T. Weber³

Authors’ Affiliations: ¹Department of Internal Medicine, Pacific Health Center, Vancouver, Canada; ²Department of Endocrinology, Karolinska Institute, Stockholm, Sweden; ³Center for Digital Health Diagnostics, Berlin, Germany

Abstract: Glycemic variability and unpredictable nocturnal hypoglycemia remain persistent clinical hurdles in the optimization of type 1 diabetes mellitus (T1DM) management. This open-label randomized controlled trial investigated the longitudinal impact of real-time continuous glucose monitoring (rt-CGM) versus conventional self-monitoring of blood glucose (SMBG) utilizing capillary blood tests at least 4 times daily. A total of 210 adult subjects with baseline HbA1c levels between 8.0% and 10.5% were monitored over 6 months. Primary endpoints included changes in time-in-range (TIR, defined as 3.9 - 10.0 mmol/L) and time-below-range (TBR < 3.9 mmol/L). The rt-CGM cohort demonstrated an absolute increase in TIR of 18.5% (corresponding to an increase of 4.4 h/day, P < 0.001) alongside a significant contraction in TBR from a baseline median of 6.2% to 1.8% of readings. Mean HbA1c in the CGM group dropped by 0.9 ± 0.3%, whereas the SMBG control arm experienced a reduction of only 0.3 ± 0.2%. Furthermore, episodes of severe nocturnal hypoglycemia requiring external assistance declined by 74% in the intervention group. Psychometric evaluation via the Diabetes Distress Scale indicated marked improvements in emotional burden and fear of hypoglycemia. These robust empirical outcomes reinforce clinical practice guidelines advocating for real-time sensor technology as a standard of care in T1DM, highlighting its capacity to transform behavioral self-management and curtail acute metabolic emergencies.

Keywords: Type 1 diabetes; Continuous glucose monitoring; Glycemic variability; Hypoglycemia; HbA1c reduction

Manuscript Timeline: Received: 10 January 2025; Revised: 08 April 2025; Accepted: 20 April 2025; Published: 05 May 2025

Citation: Chen, O. P., Johansson, Q. R., & Weber, S. T. (2025). Impact of Continuous Glucose Monitoring on Glycemic Variability and Hypoglycemia in Type 1 Diabetes Mellitus. International Journal of Medical Advances and Discoveries, 16(5), 25–32.

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