title: Benefits of short-term professional continuous glucose monitoring in clinical practice.
abstract: BACKGROUND
  The clinical utility of short-term professional continuous glucose monitoring (CGM) is uncertain.
  
  
  METHODS
  This is a retrospective review of 121 consecutive insulin-treated patients seen in a university-based subspecialty clinic who completed a 72-120-h professional CGM study. Based on the indications for the study, patients were divided into three groups: hyperglycemia (Hyper) (n=51), widely fluctuating glycemia (Fluctuating) (n=50), or hypoglycemia (Hypo) (n=20). Hemoglobin A1c (A1c) was compared before and 3-6 months after CGM. Hypoglycemia frequency was recorded by patients' self-report.
  
  
  RESULTS
  Among the entire cohort, the A1c level dropped a small amount (0.18%; P=0.04). In the Hyper group, the A1c level fell from 9.0±1.1% to 8.6±1.2% (P<0.02). In the Fluctuating group, there was no change (from 8.0±1.0% to 8.0±0.9%). The A1c level of the Hypo group patients did not change (7.6±1.1% before and after), but 14 of 20 (70%; P<0.01) had a drop in self-reported frequency of hypoglycemia. For the whole cohort, the drop in A1c level was correlated with the initial A1c value (r=0.54, P<0.01). Patients with an initial A1c level of >9.0% saw a drop of 0.7% (from 10.2±1.1% to 9.4±1.1%; P<0.01), and those with an A1c level of >7.5% saw a drop of 0.4% (from 8.9±1.2% to 8.5±1.1%; P=0.01). Subgroup analysis showed that patients with type 1 diabetes had a drop in A1c level that was not statistically significant. However, type 1 diabetes patients in the Hypo group did have a decrease in self-reported hypoglycemia (11 of 16 [68%]; P=0.03).
  
  
  CONCLUSIONS
  Professional CGM can lead to a lowering of elevated A1c levels in insulin-treated patients, especially those with type 2 diabetes. There also appears to be benefit in decreasing self-reported hypoglycemia.
authors.affiliation: Division of Endocrinology, Albany Medical College, Albany, New York 12208, USA. leinunm@mail.amc.edu
authors.forename: Matthew
authors.initials: M
authors.lastname: Leinung
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Nardacci
authors.forename: Nilem
authors.initials: N
authors.lastname: Patel
authors.forename: Shankar
authors.initials: S
authors.lastname: Bettadahalli
authors.forename: Khisar
authors.initials: K
authors.lastname: Paika
authors.forename: Shannon
authors.initials: S
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D003920:Diabetes Mellitus / Q000097:blood*; 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 / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000188:drug therapy; D007003:Hypoglycemia / Q000097:blood / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin