The COMISAIR Study shows positive results for MDI patients on CGM

COMISAIR Study comparison of insulin treatment including MDI patients on CGM

Comparison of Different Treatments for Type 1 Diabetes, Including Sensor-Augmented Insulin Regimens, in 52 Weeks of Follow-Up: A COMISAIR Study.

Šoupal J1Petruželková L2Flekač M1Pelcl T1Matoulek M1Daňková M1Škrha J1Svačina Š1Prázný M1.

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1 3rd Department of Internal Medicine, 1st Faculty of Medicine, Charles University in Prague , Czech Republic .

2 Department of Paediatrics, 2nd Faculty of Medicine, Charles University in Prague , Czech Republic .



To compare different treatment modalities for patients with type 1 diabetes (T1D) based on real-time continuous glucose monitoring (RT-CGM) or self-monitoring of blood glucose (SMBG) combined with multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII).


Sixty-five T1D patients were followed up for a year. Of these, 27 started RT-CGM as part of a sensor-augmented insulin regimen (SAIR); within this SAIR group, 15 subjects started sensor-augmented pump (SAP) therapy and the remaining 12 continued with MDIs (MDIs + RT-CGM). A second group of 20 patients initiated CSII without RT-CGM, while a third group of 18 subjects continued on MDIs and SMBG. The main endpoints were reduction of HbA1c, glycemic variability (GV), and incidence of hypoglycemia.


After a year, the baseline mean HbA1c in the SAIR group (8.3%) decreased to 7.1% (P < 0.0001); both SAIR subgroups, SAP and MDIs + RT-CGM, showed comparable improvement. The CSII group also had reduced HbA1c (8.4% ± 0.9% vs. 7.9% ± 0.7%; P < 0.05). Both SAIRs were superior to MDIs (P = 0.002) and CSII (P = 0.0032). GV was also lowered, both in the SAIR (P < 0.0001) and CSII (P < 0.05) groups. Reduced incidence of hypoglycemia was observed only with SAIR (8% ± 4% vs. 6% ± 3%; P < 0.01).


Both SAIRs, SAP and MDIs + RT-CGM, provided significant and comparable decrease of HbA1c with concurrent reduction of hypoglycemia. This improvement was greater than that seen with CSII. The combination of RT-CGM and MDIs can be a suitable alternative to SAP for some patients.

References 1 Šoupal J, Petruželková L, Flekač M et al. Comparison of Different Treatment Modalities for Type 1 Diabetes, Including Sensor-Augmented Insulin Regimens, in 52 Weeks of Follow-Up: A COMISAIR Study. Diabetes Technology & Therapeutics. 2016;18(9):532-538. 2 American Diabetes Association. (2016). Glycemic Targets. Standards of Medical Care. Diabetes Care, S39-S40. 3 Fonseca V, Grunberger G, Anhalt H et al. CONTINUOUS GLUCOSE MONITORING: A CONSENSUS CONFERENCE OF THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY. Endocr Pract. 2016;22(8):1008-1021.4 Peters A, Ahmann A, Battelino T et al. Diabetes Technology—Continuous Subcutaneous Insulin Infusion Therapy and Continuous Glucose Monitoring in Adults: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2016:jc.2016-2534.

Comisair Study MDI patients on CGM
BRIEF SAFETY STATEMENT: The Dexcom G5 Mobile Continuous Glucose Monitoring System (the “System”) is a glucose monitoring system indicated for detecting trends and tracking patterns in persons (age 2 years and older) with diabetes. CONTRAINDICATIONS: Remove the System (sensor, transmitter, and receiver) before Magnetic Resonance Imaging (MRI), Computed Tomography (CT) scan, or high-frequency electrical heat (diathermy) treatment. The System is MR Unsafe. Do not bring any portion of the System into the MR environment. Taking acetaminophen while wearing the sensor may falsely raise your sensor glucose readings. WARNING: Do not use the System for treatment decisions. The System does not replace a blood glucose meter. The System is not approved for use in pregnant women, persons on dialysis or critically ill persons. If a sensor breaks and no portion of it is visible above the skin, do not attempt to remove it. Seek professional medical help if you have infection or inflammation. Report broken sensors to Dexcom Technical Support. Sensor placement is not approved for sites other than under the skin of the belly (ages 2 years and older) or upper buttocks (ages 2-17 years). Your smart device’s internal settings override your Dexcom app settings. Accessory devices (like a smart watch) might override your smart device’s alert and notification settings. The Share feature must be turned “On” with an active internet connection to communicate glucose information to a Follower. The Follower must download and install the Dexcom Follow App onto a separate smart device with an active internet connection to receive data. Contact Dexcom Toll Free at 877-339-2664 or for detailed indications for use and safety information.