Role of continuous glucose monitoring in diabetes management

ABSTRACT

Continuous Glucose Monitoring (CGM) is among the most important recentadvances in diabetes technology for better diabetes management. The CGMprovides patients with real-time information about glucose levels, direction andrate of change, and glucose trends. There are currently four continuous glucosemonitoring devices (sensors) in clinical use which measure interstitialfluid to calculate blood glucose levels using several algorithms. These devicesinclude sensors developed by GlucoWatch®, DexComTM (DexCom SEVEN®PLUS), Medtronic (MiniMed Paradigm® REAL-Time and Guardian® REALTime),and Abbott Diabetes Care (FreeStyle Navigator®). Continuous GlucoseMonitoring is currently approved as adjunctive to Self-Monitoring of Blood Glucose(SMBG), and the CGM data should be confirmed using SMBG for treatmentdecisions. The use of CGM, both in research and clinical settings, hasbeen documented to decrease blood glucose excursions, lower HbA1c values,and reduce hypoglycemic episodes, which together diminish the risk of complicationsassociated with diabetes. In addition, use of CGM helps in reducingglucose variability. The CGM is also useful associated with special patient populationssuch as pregnant women with gestational diabetes or type 1 diabetes,children, and subjects with unexplained hypoglycemic unawareness, eventhough it is not approved by the Food and Drug Administration (FDA) for manyof these special circumstances(AU)