Personal continuous glucose monitoring (CGM) in diabetes management: review of the literature and implementation for practical use.
OBJECTIVE
Despite recent advances in diabetes therapy including the new long- and rapid-insulin analogs, insulin intensification strategies such as basal/bolus or pump therapy and sophisticated methods for insulin titration derived from the principles of functional insulin therapy, many patients fail to reach or maintain target glycosylated hemoglobin (HbA1c) values, putting them at increased risk for vascular complications. Continuous glucose monitoring (CGM) systems represent an important advance in diabetes technology that can facilitate optimal glucose control in type 1 diabetes.


METHODS
This review focuses on the efficacy and safety of CGM systems in diabetes management. The different CGM devices available are also described, as the way to use them and the educational approach to the patient in a step-by-step progression toward optimal glycemic control.


RESULTS
In type 1 diabetes, CGM systems are associated with 0.5-1% reduction in HbA1c without increased risk of hypoglycemia. CGM efficacy correlates with compliance to sensor wear, whatever the patient's age range.


CONCLUSIONS
Efficacy of CGM systems is now proven but indications, terms of use and educational issues of this new technology still need to be specified.
Caen University Hospital, Department of Endocrinology, Caen F-14000, France.
M
M
Joubert
Y
Y
Reznik
D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring / Q000379:methods* / Q000639:trends; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000097:blood* / Q000188:drug therapy / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D007332:Insulin Infusion Systems; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D011788:Quality of Life; D055815:Young Adult
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human