{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T10:36:27Z","timestamp":1793702187275,"version":"4.5.1"},"reference-count":40,"publisher":"American Diabetes Association","issue":"12","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"funder":[{"DOI":"10.13039\/100011946","name":"Abbott Diabetes Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011946","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>We assessed the impact of intermittently scanned continuous glucose monitoring (isCGM) compared with blood glucose monitoring (BGM) on rates of hospitalization for metabolic and vascular complications of diabetes and on HbA1c levels for adults with type 1 diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>This retrospective study using data from the Swedish National Diabetes Register and the Swedish National Patient Register comprised adults with type 1 diabetes and an isCGM initiation date after 1 June 2017 and matched control individuals using BGM. Hospital admission rates were calculated per 100 person-years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We identified 11,822 adults with type 1 diabetes and an isCGM index date after 1 June 2017 and HbA1c baseline values 3\u20138 months prior to the index date. Compared with 3,007 BGM users, isCGM users had a significantly lower relative risk of hospitalization for hypoglycemia (0.32; 95% CI 0.14, 0.74), diabetic ketoacidosis (0.55; 0.35, 0.87), stroke (0.48; 0.37, 0.64), acute myocardial infarction (0.64; 0.46, 0.91), atrial fibrillation (0.59; 0.38, 0.94), heart failure (0.25; 0.16, 0.39), peripheral vascular disease (0.21; 0.07, 0.62), kidney disease (0.48; 0.35, 0.66), or hospitalization for any reason (0.32; 0.29, 0.35). Compared with BGM users, change in mean HbA1c for isCGM users was \u22120.30% (\u22123.3 mmol\/mol) at 6 months and \u22120.24% (\u22122.6 mmol\/mol) at 24 months (both P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>This study shows that adults with type 1 diabetes in Sweden who initiate isCGM have significantly reduced hospitalization rates for acute diabetes events, kidney disease, and cardiovascular complications, along with improved glucose control, compared with BGM users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc24-0690","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T11:22:27Z","timestamp":1727176947000},"page":"2164-2171","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":22,"title":["Initiation of Intermittently Scanned Continuous Glucose Monitoring Is Associated With Reduced Hospitalization for Acute Diabetes Events and Cardiovascular Complications in Adults With Type 1 Diabetes"],"prefix":"10.2337","volume":"47","author":[{"given":"Katarina","family":"Eeg-Olofsson","sequence":"first","affiliation":[{"name":"1Sahlgrenska University Hospital and Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden"},{"name":"2Centre of Registers, V\u00e4stra G\u00f6taland Region, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Nathanson","sequence":"additional","affiliation":[{"name":"3Karolinska University Hospital and Medical Unit Endocrinology and Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Spelman","sequence":"additional","affiliation":[{"name":"4Synergus RWE AB, \u00c5kersberga, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Kyhlstedt","sequence":"additional","affiliation":[{"name":"4Synergus RWE AB, \u00c5kersberga, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"B\u00fclow","sequence":"additional","affiliation":[{"name":"2Centre of Registers, V\u00e4stra G\u00f6taland Region, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fleur","family":"Levrat-Guillen","sequence":"additional","affiliation":[{"name":"5Abbott Laboratories Ltd., Maidenhead, U.K."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0035-0142","authenticated-orcid":false,"given":"Jan","family":"Bolinder","sequence":"additional","affiliation":[{"name":"3Karolinska University Hospital and Medical Unit Endocrinology and Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"2024112719514639600_B1","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1007\/s00125-021-05568-3","article-title":"The management of type 1 diabetes in adults. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)","volume":"64","author":"Holt","year":"2021","journal-title":"Diabetologia"},{"key":"2024112719514639600_B2","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1007\/s13300-022-01253-9","article-title":"Reductions in HbA1c with flash glucose monitoring are sustained for up to 24 months: a meta-analysis of 75 real-world observational studies","volume":"13","author":"Evans","year":"2022","journal-title":"Diabetes Ther"},{"key":"2024112719514639600_B3","doi-asserted-by":"crossref","first-page":"2254","DOI":"10.1016\/S0140-6736(16)31535-5","article-title":"Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial","volume":"388","author":"Bolinder","year":"2016","journal-title":"Lancet"},{"key":"2024112719514639600_B4","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2337\/dc19-1610","article-title":"Quality of life and glucose control after 1 year of nationwide reimbursement of intermittently scanned continuous glucose monitoring in adults living with type 1 diabetes (future): a prospective observational real-world cohort study","volume":"43","author":"Charleer","year":"2020","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B5","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.2337\/dc20-0738","article-title":"Effect of flash glucose monitoring on glycemic control, hypoglycemia, diabetes-related distress, and resource utilization in the Association of British Clinical Diabetologists (ABCD) nationwide audit","volume":"43","author":"Deshmukh","year":"2020","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B6","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.2337\/dc20-1690","article-title":"Important drop in rate of acute diabetes complications in people with type 1 or type 2 diabetes after initiation of flash glucose monitoring in France: the RELIEF study","volume":"44","author":"Roussel","year":"2021","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B7","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1089\/dia.2022.0085","article-title":"Reduced rate of acute diabetes events with flash glucose monitoring is sustained for 2 years after initiation: extended outcomes from the RELIEF study","volume":"24","author":"Riveline","year":"2022","journal-title":"Diabetes Technol Ther"},{"key":"2024112719514639600_B8","unstructured":"Swedish National Diabetes Registry Annual Report 2022. Accessed 3 May 2024. Available from https:\/\/www.ndr.nu\/pdfs\/Arsrapport_NDR_2022.pdf"},{"key":"2024112719514639600_B9","unstructured":"Swedish national guidelines for diabetes care. Review 2018 (Socialstyrelsen). Accessed 3 May 2024. Available from https:\/\/www.socialstyrelsen.se\/globalassets\/sharepoint-dokument\/artikelkatalog\/nationella-riktlinjer\/2018-10-25.pdf"},{"key":"2024112719514639600_B10","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1007\/s00125-021-05437-z","article-title":"Effect of flash glucose monitoring in adults with type 1 diabetes: a nationwide, longitudinal observational study of 14,372 flash users compared with 7691 glucose sensor naive controls","volume":"64","author":"Nathanson","year":"2021","journal-title":"Diabetologia"},{"key":"2024112719514639600_B11","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish National Inpatient Register","volume":"11","author":"Ludvigsson","year":"2011","journal-title":"BMC Public Health"},{"key":"2024112719514639600_B12","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1373\/clinchem.2003.024802","article-title":"IFCC reference system for measurement of hemoglobin A1c in human blood and the national standardization schemes in the United States, Japan, and Sweden: a method-comparison study","volume":"50","author":"Hoelzel","year":"2004","journal-title":"Clin Chem"},{"key":"2024112719514639600_B13","doi-asserted-by":"crossref","first-page":"1903","DOI":"10.2337\/dc10-0953","article-title":"2010 Consensus statement on the worldwide standardization of the hemoglobin A1c measurement","volume":"33","author":"Hanas","year":"2010","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B14","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1001\/jama.2019.21558","article-title":"Using propensity score methods to create target populations in observational clinical research","volume":"323","author":"Thomas","year":"2020","journal-title":"JAMA"},{"key":"2024112719514639600_B15","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1080\/00273171.2011.568786","article-title":"An introduction to propensity score methods for reducing the effects of confounding in observational studies","volume":"46","author":"Austin","year":"2011","journal-title":"Multivariate Behav Res"},{"key":"2024112719514639600_B16","volume-title":"Statistical Power Analysis for the Behavioral Sciences.","author":"Cohen","year":"1988"},{"key":"2024112719514639600_B17","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1093\/aje\/kwq439","article-title":"Doubly robust estimation of causal effects","volume":"173","author":"Funk","year":"2011","journal-title":"Am J Epidemiol"},{"key":"2024112719514639600_B18","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1210\/jc.2017-02498","article-title":"Effect of continuous glucose monitoring on glycemic control, acute admissions, and quality of life: a real-world study","volume":"103","author":"Charleer","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2024112719514639600_B19","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1007\/s00592-023-02079-y","article-title":"The use of isCGM leads to marked reduction in severe hypoglycemia requiring emergency medical service or hospital admission and diabetic ketoacidosis in adult type 1 diabetes patients","volume":"60","author":"Mustonen","year":"2023","journal-title":"Acta Diabetol"},{"key":"2024112719514639600_B20","doi-asserted-by":"crossref","first-page":"e3355","DOI":"10.1002\/dmrr.3355","article-title":"Impact of flash glucose monitoring on glucose control and hospitalization in type 1 diabetes: a nationwide cohort study","volume":"37","author":"Tsur","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"2024112719514639600_B21","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/S2213-8587(21)00190-X","article-title":"Cardiovascular disease in type 1 diabetes: a continuing challenge","volume":"9","author":"Orchard","year":"2021","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2024112719514639600_B22","doi-asserted-by":"crossref","first-page":"798","DOI":"10.2337\/diacare.29.04.06.dc05-1433","article-title":"High risk of cardiovascular disease in patients with type 1 diabetes in the U.K.: a cohort study using the general practice research database","volume":"29","author":"Soedamah-Muthu","year":"2006","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B23","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1056\/NEJMoa1408214","article-title":"Glycemic control and excess mortality in type 1 diabetes","volume":"371","author":"Lind","year":"2014","journal-title":"N Engl J Med"},{"key":"2024112719514639600_B24","doi-asserted-by":"crossref","first-page":"1370","DOI":"10.2337\/db15-1517","article-title":"Risk Factors for Cardiovascular Disease in Type 1 Diabetes","volume":"65","author":"Diabetes Control and Complications Trial\/Epidemiology of Diabetes Interventions and Complications (DCCT\/EDIC) Research Group","year":"2016","journal-title":"Diabetes"},{"key":"2024112719514639600_B25","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S2213-8587(18)30315-2","article-title":"Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management","volume":"7","author":"Amiel","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2024112719514639600_B26","doi-asserted-by":"crossref","first-page":"2643","DOI":"10.1056\/NEJMoa052187","article-title":"Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes","volume":"353","author":"Nathan","year":"2005","journal-title":"N Engl J Med"},{"key":"2024112719514639600_B27","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1056\/NEJM199309303291401","article-title":"The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus","volume":"329","author":"Nathan","year":"1993","journal-title":"N Engl J Med"},{"key":"2024112719514639600_B28","doi-asserted-by":"crossref","first-page":"686","DOI":"10.2337\/dc15-1990","article-title":"Intensive diabetes treatment and cardiovascular outcomes in type 1 diabetes: The DCCT\/EDIC study 30-year follow-up","volume":"39","author":"Diabetes Control and Complications Trial (DCCT)\/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group","year":"2016","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B29","doi-asserted-by":"crossref","first-page":"e15249","DOI":"10.1111\/dme.15249","article-title":"Intermittently scanned continuous glucose monitoring in adults with type 1 diabetes: a subgroup analysis from the FLASH-UK study","volume":"41","author":"Leelarathna","year":"2024","journal-title":"Diabet Med"},{"key":"2024112719514639600_B30","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00125-021-05578-1","article-title":"Flash monitor initiation is associated with improvements in HbA1c levels and DKA rates among people with type 1 diabetes in Scotland: a retrospective nationwide observational study","volume":"65","author":"Jeyam","year":"2022","journal-title":"Diabetologia"},{"key":"2024112719514639600_B31","doi-asserted-by":"crossref","first-page":"117158","DOI":"10.1016\/j.atherosclerosis.2023.06.005","article-title":"Cardiovascular disease in type 1 diabetes, an underestimated danger: Epidemiological and pathophysiological data","volume":"394","author":"Verg\u00e8s","year":"2024","journal-title":"Atherosclerosis"},{"key":"2024112719514639600_B32","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s11883-013-0351-7","article-title":"Hypoglycemia as a driver of cardiovascular risk in diabetes","volume":"15","author":"Moheet","year":"2013","journal-title":"Curr Atheroscler Rep"},{"key":"2024112719514639600_B33","doi-asserted-by":"crossref","first-page":"400","DOI":"10.2337\/dc18-1444","article-title":"Validation of time in range as an outcome measure for diabetes clinical trials","volume":"42","author":"Beck","year":"2018","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B34","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1111\/jdi.13811","article-title":"Comparison of glucose time in range and area under curve in range in relation to risk of diabetic retinopathy in type\u20092 diabetes patients","volume":"13","author":"Wang","year":"2022","journal-title":"J Diabetes Investig"},{"key":"2024112719514639600_B35","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1089\/dia.2019.0499","article-title":"Association between continuous glucose monitoring-derived time in range, other core metrics, and albuminuria in type 2 diabetes","volume":"22","author":"Yoo","year":"2020","journal-title":"Diabetes Technol Ther"},{"key":"2024112719514639600_B36","doi-asserted-by":"crossref","first-page":"549","DOI":"10.2337\/dc20-1862","article-title":"Time in range in relation to all-cause and cardiovascular mortality in patients with type 2 diabetes: a prospective cohort study","volume":"44","author":"Lu","year":"2021","journal-title":"Diabetes Care"},{"key":"2024112719514639600_B37","doi-asserted-by":"crossref","first-page":"e002573","DOI":"10.1136\/bmjdrc-2021-002573","article-title":"Time in range, as measured by continuous glucose monitor, as a predictor of microvascular complications in type 2 diabetes: a systematic review","volume":"10","author":"Raj","year":"2022","journal-title":"BMJ Open Diabetes Res Care"},{"key":"2024112719514639600_B38","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.eprac.2023.01.001","article-title":"Correlation between hemoglobin glycation index measured by continuous glucose monitoring with complications in type 1 diabetes","volume":"29","author":"Ibarra-Salce","year":"2023","journal-title":"Endocr Pract"},{"key":"2024112719514639600_B39","doi-asserted-by":"crossref","first-page":"e570","DOI":"10.1210\/clinem\/dgab688","article-title":"Relationship between time in range, glycemic variability, HbA1c, and complications in adults with type 1 diabetes mellitus","volume":"107","author":"El Malahi","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2024112719514639600_B40","doi-asserted-by":"crossref","first-page":"h3234","DOI":"10.1136\/bmj.h3234","article-title":"Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18,168 people with type 1 diabetes: observational study","volume":"350","author":"Steineck","year":"2015","journal-title":"BMJ"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/47\/12\/2164\/790811\/dc240690.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/47\/12\/2164\/790811\/dc240690.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T14:52:14Z","timestamp":1732719134000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/47\/12\/2164\/157287\/Initiation-of-Intermittently-Scanned-Continuous"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,24]]},"references-count":40,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,9,24]]},"published-print":{"date-parts":[[2024,12,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc24-0690","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,24]]}}}