Irl B Hirsch1. 1. University of Washington School of Medicine, Seattle, Washington 98105, USA. ihirsch@u.washington.edu
Abstract
CONTEXT: Real-time continuous glucose monitoring (CGM) has been available for type 1 diabetes for several years. This paper is a status report on our early experiences with this next technology. EVIDENCE ACQUISITION: The two major sources of data acquisition included PubMed search strategies and personal experience of the author from clinical experience. EVIDENCE SYNTHESIS: Data assessing CGM accuracy, short-term outcomes (12 wk), and longer term outcomes (6 months) are reported. Potential strategies for successful and efficient use in an office or clinic setting are also discussed. Practical aspects of CGM use (alarm settings, using glycemic trending information) are also reviewed. CONCLUSIONS: Accuracy of this technology has improved in the short amount of time it has been available. Six-month data suggest that patient selection is a key for success. Patients who do not understand or practice the basics of intensive insulin therapy have the greatest challenges. Those who do best watch the receiver frequently, continue with frequent home blood glucose monitoring, use the trending information to make insulin adjustments, and understand the limitations of the technology. With insurance reimbursement improving, CGM is gaining acceptance as an important tool for the management of type 1 diabetes. Like home blood glucose monitoring and insulin pump therapy, this technology by itself is not a panacea for diabetes control. However, it further adds to our ability to improve the lives of people with diabetes. Long-term, the hope is that this technology will pave the way for a "closed-loop" device.
CONTEXT: Real-time continuous glucose monitoring (CGM) has been available for type 1 diabetes for several years. This paper is a status report on our early experiences with this next technology. EVIDENCE ACQUISITION: The two major sources of data acquisition included PubMed search strategies and personal experience of the author from clinical experience. EVIDENCE SYNTHESIS: Data assessing CGM accuracy, short-term outcomes (12 wk), and longer term outcomes (6 months) are reported. Potential strategies for successful and efficient use in an office or clinic setting are also discussed. Practical aspects of CGM use (alarm settings, using glycemic trending information) are also reviewed. CONCLUSIONS: Accuracy of this technology has improved in the short amount of time it has been available. Six-month data suggest that patient selection is a key for success. Patients who do not understand or practice the basics of intensive insulin therapy have the greatest challenges. Those who do best watch the receiver frequently, continue with frequent home blood glucose monitoring, use the trending information to make insulin adjustments, and understand the limitations of the technology. With insurance reimbursement improving, CGM is gaining acceptance as an important tool for the management of type 1 diabetes. Like home blood glucose monitoring and insulin pump therapy, this technology by itself is not a panacea for diabetes control. However, it further adds to our ability to improve the lives of people with diabetes. Long-term, the hope is that this technology will pave the way for a "closed-loop" device.
Authors: Linda Morrow; Marcus Hompesch; Ann M Tideman; Jennifer Matson; Nancy Dunne; Scott Pardo; Joan L Parkes; Holly C Schachner; David A Simmons Journal: J Diabetes Sci Technol Date: 2011-07-01
Authors: Marcus Lind; William Polonsky; Irl B Hirsch; Tim Heise; Jan Bolinder; Sofia Dahlqvist; Nils-Gunnar Pehrsson; Peter Moström Journal: J Diabetes Sci Technol Date: 2016-05-03
Authors: Mustafa Omami; James J McGarrigle; Mick Reedy; Douglas Isa; Sofia Ghani; Enza Marchese; Matthew A Bochenek; Maha Longi; Yuan Xing; Ira Joshi; Yong Wang; José Oberholzer Journal: Curr Diab Rep Date: 2017-07 Impact factor: 4.810