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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe Minimally Invasive Technology Role and Evaluation [MITRE] Study, a randomized controlled trial of continuous glucose monitoring device use, showed them to be of no greater benefit than standard care. This article discusses the report that all groups, including controls, had a sustained reduction of HbA1C.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ehyperglycemia\/hypoglycemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ediabetes \u0026amp; endocrinology clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EThe MITRE (Minimally Invasive Technology Role and Evaluation) Study, a randomized controlled trial of continuous glucose monitoring device use, showed them to be of no greater benefit than standard care. Stanton Newman, PhD, University College, London, UK, reported that all groups, including controls, had a sustained reduction of HbA1c.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EProf. Newman said that prior to MITRE, clinical trial evidence regarding the use of continuous glucose monitoring devices was limited by small sample size, the inclusion primarily of type 1 diabetes patients, and the increased attention given to those receiving the continuous glucose monitoring device. The objective of MITRE was to compare the benefits of using the GlucoWatch\u00ae G2\u2122 Biographer (Animas) and the Continuous Glucose Monitoring System (CGMS\u00ae, MiniMed) on HbA1c versus attention control and standard treatment in a randomized controlled trial. Percentage change in HbA1c from baseline to 6, 12, and 18 months was the primary endpoint.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EPatients were randomly assigned to one of MITRE\u0027s four study arms (\u223c100 patients each). The groups differed as follows:\u003C\/p\u003E\n         \u003Cul class=\u0022list-unord \u0022 id=\u0022list-1\u0022\u003E\u003Cli id=\u0022list-item-1\u0022\u003E\n               \u003Cp id=\u0022p-5\u0022\u003EStandard Control (baseline visit only asked to test capillary blood glucose at normal frequency with Lifescan Onetouch Ultra Meter\u00ae), continued with standard care.\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-2\u0022\u003E\n               \u003Cp id=\u0022p-6\u0022\u003EAttention Control (feedback based on self-monitoring of blood glucose)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-3\u0022\u003E\n               \u003Cp id=\u0022p-7\u0022\u003EGlucoWatch (used at times of patient choice; recommended minimum of 4x\/month and maximum of 4x\/week)\u003C\/p\u003E\n            \u003C\/li\u003E\u003Cli id=\u0022list-item-4\u0022\u003E\n               \u003Cp id=\u0022p-8\u0022\u003ECGMS (fitted at 3, 6, and 12 weeks and worn for 72 hours each time)\u003C\/p\u003E\n            \u003C\/li\u003E\u003C\/ul\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EThe participants in the two treatment groups and the attention placebo group attended three research visits. The attention control group was included to control for the impact of increased levels of contact with health care professionals in the two device groups. Planned visits were conducted with nurses trained specifically on use of the MITRE devices, interpretation of blood glucose results and delivery of appropriate feedback to patients.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EThe study population included individuals \u226518 years of age with insulin-requiring diabetes (\u22652 injections\/day), diabetes duration \u0026gt;6 months, and two consecutive HbA1c measurements \u22657.5%.\u003C\/p\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EMean age was \u223c52 years (55% men) with 57% having type 1 diabetes. Mean HbA1c, which was 9.1% at baseline, declined in all groups, although the effect waned over time. At 18 months, the reduction was 1% for the GlucoWatch group and between 4% and 5% for the other groups, with no significant differences at any time point. In the GlucoWatch group 15% of patients achieved a reduction of 12.5% from baseline HbA1c versus 29% in the CGMS group. None of the differences was significant at any time point.\u003C\/p\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EMonitor use declined over time, with 20% continuing to use the GlucoWatch and 67% continuing to use CGMS. Hypoglycemic events were similar between groups. CGMS-derived information tended to alter clinical feedback more than that from GlucoWatch.\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EProf. Newman concluded, \u201cThere was no group effect on HbA1c of minimally invasive monitors relative to attention control or standard control.\u201d He commented also that with all groups showing a sustained HbA1c reduction, trial participation may have led to improved metabolic control, obscuring any effects of devices.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2007 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/7\/6\/12.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm821\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}