Use of continuous glucose monitoring in patients with type 1 diabetes

Curr Diabetes Rev. 2008 Aug;4(3):207-17. doi: 10.2174/157339908785294370.

Abstract

The prevalence of type 1 diabetes continues to increase worldwide at a rate higher than previously projected, while the number of patients achieving American Diabetes Association (ADA) glycated hemoglobin (A1c) goals remains suboptimal. There are numerous barriers to patients achieving A1c targets including increased frequency of severe hypoglycemia associated with lowering plasma glucose as measured by lower A1c values. Continuous glucose monitoring (CGM) was first approved for retrospective analysis and now has advanced to the next step in diabetes management with the approval of real-time glucose sensing. Real-time CGM, in short term studies, has been shown to decrease A1c values, improve glucose variability (GV), and minimize the time and number of hypoglycemic events in patients with type 1 diabetes. These products are approved for adjunctive use to self-monitoring of blood glucose (SMBG), but future long-term studies are needed to document their safety, efficacy, ability to replace SMBG as a tool of monitoring, and ultimately utility into closed-loop insulin delivery systems. New algorithms will need to be developed that account for rapid changes in the glucose values, so that accuracy of the sensor data can be maintained. In addition, for better clinical care and usage, algorithms also need to be developed for both patients and the providers to guide them for their ongoing diabetes care.

Publication types

  • Review

MeSH terms

  • Biosensing Techniques
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring / instrumentation
  • Blood Glucose Self-Monitoring / methods
  • Diabetes Mellitus, Type 1 / blood*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Equipment Design
  • Glycated Hemoglobin / analysis
  • Humans
  • Hyperglycemia / blood
  • Hypoglycemia / blood
  • Monitoring, Ambulatory / instrumentation
  • Monitoring, Ambulatory / methods*
  • Prevalence
  • Self Care
  • United States / epidemiology

Substances

  • Blood Glucose
  • Glycated Hemoglobin A