Indications/Applications
Potential adult patients for CGM technology include1:
- Those with type 1 diabetes who are not reaching their target HbA1c levels with SMBG
- Those who intentionally maintain above-target blood sugar levels for fear of hypoglycaemia
- Those with hypoglycaemia unawareness or frequent episodes of hypoglycaemia
Evidence
The effectiveness of CGM is scientifically proven The advantages of CGM over traditional fingersticks and HbA1c testing are well documented. Research has shown that:
- 60% of glucose lows may not be revealed with fingersticks alone.2
- CGM identifies four times as many serious glucose excursions as self-monitoring of blood glucose(SMBG).3
- CGM can significantly reduce HbA1c levels when compared with fingersticks alone.4,5
- CGM is proven to be accurate in numerous published studies6,7,8 enabling you to make therapy adjustments based on reliable data.
1Hirsch IB, Armstrong D, Bergenstal RM, et al. Clinical Application of Emerging Sensor Technologies in Diabetes Management: Consensus Guidelines for Continuous Glucose Monitoring (CGM). Diab Tech Thera. 2008;10(4):232-246.
2Pitzer KR, Desai S, Dunn T, et al. Detection of hypoglycemia with the GlucoWatch biographer. Diab Care. 2001;24(5):881-885.
3Kaufman FR, Gibson LC, Halvorson M, Carpenter S, Fisher LK, Pitukcheewanont P. A pilot study of the continuous glucose monitoring system: Clinical decisions and glycemic control after its use in pediatric type 1 diabetic subjects. Diab Care. 2001;24(12):2030-2034.
4Deiss D, Bolinder J, Riveline JP et al. Improved Glycemic Control in Poorly Controlled Patients with Type 1 Diabetes Using Real-Time Continuous Glucose Monitoring. Diab Care. 2006;29(12):2730-2732.
5The JDRF CGM study group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. NEJM. 2008; 359:1464-76.
6NICE Clinical Guidelines. Clinical Guidelines for the Diagnosis and Management of Type 1 Diabetes in Children, Young People, and Adults. Available at: http://www.nice.org.uk/Guidance/CG15. Accessed January 21, 2009.
7American Diabetes Association. Standards of medical care in diabetes — 2007. Diab Care. 2007;30 (Suppl 1):S4-S41.
8Tansey M, Tsalikan E, Beck RW, Fiallo-Scharer R, Janz K, Fox L, Wilson D, Weinzimer S, Tamborlane W, Steffes M, Xing D, Ruedy K, and the Diabetes Research in Children Network (DirecNet) Study Group. Stopping basal insulin during exercise markedly reduces the risk of hypoglycemia in children with type 1 diabetes on insulin pump therapy. Diabetes. 2006;55(Suppl 1):A240(Poster).