title: Continuous glucose monitoring in type 1 diabetes.
abstract: Continuous glucose monitors (CGM), devices that can measure interstitial glucose in "real time," have become widely available particularly for use in patients with diabetes, and their accuracy and ease of use have greatly improved over the last decade. A number of large and well-controlled clinical trials have firmly established their usefulness in improving metabolic control (as measured by HbA1C) and decreasing time spent in hypoglycemia in adults; however, data have been less robust proving benefit in children and adolescents. Benefits are clearly linked to near-continuous wear. Insulin dosing algorithms based on CGM glucose trends have proven useful in dissecting the large volume of data generated daily by these devices, although these are imperfect tools, particularly in children. The technology is likely to be most useful when integrated with insulin pump delivery systems (sensor augmented). In this review, we concentrate on the analysis of published results of the largest trials in adults and children, including the very young, with diabetes.
authors.affiliation: Nemours Children's Clinic, 807 Children's Way, Jacksonville, FL 32207, USA. nmauras@nemours.org
authors.forename: Nelly
authors.initials: N
authors.lastname: Mauras
authors.forename: Larry
authors.initials: L
authors.lastname: Fox
authors.forename: Kimberly
authors.initials: K
authors.lastname: Englert
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism*; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000378:metabolism*; D045604:Extracellular Fluid / Q000378:metabolism; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007332:Insulin Infusion Systems / Q000009:adverse effects; D008297:Male; D018670:Monitoring, Ambulatory / Q000009:adverse effects / Q000295:instrumentation; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000188:drug therapy / Q000378:metabolism; D011788:Quality of Life
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin