Friday’s symposium Pains and Gains in Continuous Glucose Monitoring (CGM) will explore a range of topics, including advances in device technology, outcomes and indications, CGM in special populations, and uniform metrics in CGM. ADAMeetingNews.org spoke with two of the session’s presenters about the topics they will be discussing during the two-hour symposium, which begins at 4:15 p.m. in N-Hall E (North, Exhibition Level).
Continuous Glucose Monitoring Is Trending—Device Options and Utilization
Roy W. Beck, MD, PhD, Executive Director of the Jaeb Center for Health Research
Dr. Beck: Since the introduction of the first continuous glucose monitoring devices in the early 2000s, continual advances in sensor technology have led to devices that are more accurate, more compact, more durable, and more user-friendly. Previously approved as an adjunctive to blood glucose meters (BGM), several CGM devices have been recently approved in the U.S. and Europe for use as replacements to BGM for insulin dosing.
- CGM has evolved substantially to the point where accuracy approaches that of many blood glucose meters.
- Use of CGM has increased exponentially in the last few years.
- Patient satisfaction with CGM is much higher than it was with earlier-generation CGMs in both insulin pump users and insulin injection users.
- Improvement in glucose control and quality of life can be expected with CGM.
- Future-generation CGM sensors will be smaller, disposable, and cheaper.
Dr. Beck: CGM should be considered for all patients with type 1 diabetes and those with type 2 diabetes using insulin. In the future, CGM may be demonstrated to be of value for patients with type 2 diabetes not using insulin.
Beyond A1C—Applying Uniform Metrics in the Clinical Use of Continuous Glucose Monitoring
Anders L. Carlson, MD, Medical Director of the International Diabetes Center
Dr. Carlson: There’s a lot of interest right now in how best to interpret and clinically apply all the data we get from continuous glucose monitors. Both clinicians and patients will benefit from having a uniform way of reporting and discussing various glucose metrics like time in range and glucose management indicator (GMI). Time in range, in particular, is a concept that’s easily understandable by patients and can be used to individualize treatment decisions in a way A1C alone never allows.
Dr. Carlson: I will show some data to suggest that time in range (70 mg/dL to 180 mg/dL) correlates with diabetes complications, and also serves as an outcome for clinical research. I will give detail into the concept of GMI, and also pare down the international consensus on CGM metrics to 10 metrics that I think are very helpful in everyday clinical practice.
Dr. Carlson: I hope people who attend the session will leave with a better understanding of why CGM metrics need to be standardized, and how these different measurements can be used routinely in clinical care. I will show how CGM data can be displayed on the ambulatory glucose profile and used for data interpretation.
The diabetes field is starting to move away from A1C as the main driver of a patient’s therapeutic recommendations, and with CGM data we can personalize treatment decisions and also react to changes more rapidly, rather than waiting three months until the next A1C test.