Improved quality of glycemic control and reduced glycemic variability with use of continuous glucose monitoring.
OBJECTIVE
We evaluated effects of unmasking of continuous display of continuous glucose monitoring (CGM) on quality of glycemic control and glycemic variability.


METHODS
We reanalyzed CGM data from 85 patients using a 7-day glucose sensor. Glucose values were "masked" during the first week but "unmasked" during the next 2 weeks. We evaluated 48 criteria for quality of glycemic control, including mean glucose, SD, percentage of values within-, above- or below- specified ranges, Schlichtkrull's M(100) index, mean amplitude of glycemic excursion (MAGE), mean of daily differences (MODD), the J index, "Index of Glycemic Control" (IGC), Hyperglycemia Index, Hypoglycemia Index, High Blood Glucose Index (HBGI), Low Blood Glucose Index (LBGI), average daily risk range (ADRR), GRADE scores, and CONGA(n). We calculated SD values between daily means, between days-within time points, within days, between time points (for the average glucose profile for several days), and within series for time segments of arbitrary length.


RESULTS
Unmasking CGM displays resulted in rapid, highly statistically significant improvement in 29 indices, including percentage within, percentage above, and percentage below target range, mean glucose, SD, SD of daily means, MODD, M(100), IGC, GRADE, HBGI, and J index. Both hyperglycemia and hypoglycemia improved during the first week after unmasking; further improvement in hypoglycemia was seen during the following week. Results obtained using multiple criteria were consistent and highly correlated.


CONCLUSIONS
Continuous access to display of CGM sensors dramatically improved 29 indices of glycemic control and glycemic variability.
Rodbard
David
D
Biomedical Informatics Consultants, Potomac, Maryland 20854-4721, USA. drodbard@comcast.net <drodbard@comcast.net>
Bailey
Timothy
T
Jovanovic
Lois
L
Zisser
Howard
H
Kaplan
Roy
R
Garg
Satish K
SK
D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring; D004435:Eating; D038321:Glycemic Index; D006801:Humans; D007003:Hypoglycemia / Q000378:metabolism
D001786:Blood Glucose