CGM—How Good Is Good Enough?
Continuous glucose monitoring (CGM) systems are more informative than the traditional self-monitoring of capillary blood glucose (BG). Although advances in CGM technology have significantly improved the clinical utility of CGM devices compared with earlier versions, it is often difficult to assess the accuracy and precision of current devices due to differences in assessment protocols and reporting of results. Because CGM sensor accuracy can impact both the clinical utility and patient acceptance of CGM use, it is important to consider the performance characteristics seen in the current systems when assessing the clinical value of this technology. Moreover, standardization of the metrics used to assess CGM accuracy and precision are needed to help developers, clinicians, and patients make informed decisions regarding the CGM systems they are considering. In this chapter, we discuss the most commonly used methods for the assessment of CGM system performance, the accuracy and reliability of current CGM systems, and the remaining unsolved technological and physiological hurdles.
- # Continuous Glucose Monitoring Systems
- # Continuous Glucose Monitoring
- # Self-monitoring Of Capillary Blood Glucose
- # Continuous Glucose Monitoring Technology
- # Current Systems
- # Continuous Glucose Monitoring Use
- # Physiological Hurdles
- # Assessment Protocols
- # Earlier Versions
- # Assessment Of System Reliability
- Research Article
40
- 10.1089/dia.2015.0296
- Feb 1, 2016
- Diabetes Technology & Therapeutics
Continuous glucose monitoring (CGM) systems have been available for more than 15 years by now. However, market uptake is relatively low in most countries; in other words, relatively few patients with diabetes use CGM systems regularly. One major reason for the reluctance of patients to use CGM systems is the costs associated (i.e., in most countries no reimbursement is provided by the health insurance companies). In case reimbursement is in place, like in the United States, only certain patient groups get reimbursement that fulfills strict indications. This situation is somewhat surprising in view of the mounting evidence for benefits of CGM usage from clinical trials: most meta-analyses of these trials consistently show a clinically relevant improvement of glucose control associated with a reduction in hypoglycemic events. More recent trials with CGM systems with an improved CGM technology showed even more impressive benefits, especially if CGM systems are used in different combinations with an insulin pump (e.g., with automated bolus calculators and low glucose suspend features). Nevertheless, sufficient evidence is not available for all patient groups, and more data on cost-efficacy are needed. In addition, good data from real-world studies/registers documenting the benefits of CGM usage under daily life conditions would be of help to convince healthcare systems to cover the costs of CGM systems. In view of the ongoing improvements in established needle-type CGM systems, the fact that new CGM technology will come to the market soon (e.g., implantable sensors), that CGM-like systems are quite successfully at least in certain markets (like the flash glucose monitoring systems), and that the first artificial pancreas systems will come to the market in the next few years, there is a need to make sure that this major improvement in diabetes therapy becomes more widely available for patients with diabetes, for which better reimbursement is essential.
- Research Article
71
- 10.3310/hta20170
- Feb 1, 2016
- Health technology assessment (Winchester, England)
In recent years, meters for continuous monitoring of interstitial fluid glucose have been introduced to help people with type 1 diabetes mellitus (T1DM) to achieve better control of their disease. The objective of this project was to summarise the evidence on the clinical effectiveness and cost-effectiveness of the MiniMed(®) Paradigm™ Veo system (Medtronic Inc., Northridge, CA, USA) and the Vibe™ (Animas(®) Corporation, West Chester, PA, USA) and G4(®) PLATINUM CGM (continuous glucose monitoring) system (Dexcom Inc., San Diego, CA, USA) in comparison with multiple daily insulin injections (MDIs) or continuous subcutaneous insulin infusion (CSII), both with either self-monitoring of blood glucose (SMBG) or CGM, for the management of T1DM in adults and children. A systematic review was conducted in accordance with the principles of the Centre for Reviews and Dissemination guidance and the National Institute for Health and Care Excellence Diagnostic Assessment Programme manual. We searched 14 databases, three trial registries and two conference proceedings from study inception up to September 2014. In addition, reference lists of relevant systematic reviews were checked. In the absence of randomised controlled trials directly comparing Veo or an integrated CSII + CGM system, such as Vibe, with comparator interventions, indirect treatment comparisons were performed if possible. A commercially available cost-effectiveness model, the IMS Centre for Outcomes Research and Effectiveness diabetes model version 8.5 (IMS Health, Danbury, CT, USA), was used for this assessment. This model is an internet-based, interactive simulation model that predicts the long-term health outcomes and costs associated with the management of T1DM and type 2 diabetes. The model consists of 15 submodels designed to simulate diabetes-related complications, non-specific mortality and costs over time. As the model simulates individual patients over time, it updates risk factors and complications to account for disease progression. Fifty-four publications resulting from 19 studies were included in the review. Overall, the evidence suggests that the Veo system reduces hypoglycaemic events more than other treatments, without any differences in other outcomes, including glycated haemoglobin (HbA1c) levels. We also found significant results in favour of the integrated CSII + CGM system over MDIs with SMBG with regard to HbA1c levels and quality of life. However, the evidence base was poor. The quality of the included studies was generally low, often with only one study comparing treatments in a specific population at a specific follow-up time. In particular, there was only one study comparing Veo with an integrated CSII + CGM system and only one study comparing Veo with a CSII + SMBG system in a mixed population. Cost-effectiveness analyses indicated that MDI + SMBG is the option most likely to be cost-effective, given the current threshold of £30,000 per quality-adjusted life-year gained, whereas integrated CSII + CGM systems and Veo are dominated and extendedly dominated, respectively, by stand-alone, non-integrated CSII with CGM. Scenario analyses did not alter these conclusions. No cost-effectiveness modelling was conducted for children or pregnant women. The Veo system does appear to be better than the other systems considered at reducing hypoglycaemic events. However, in adults, it is unlikely to be cost-effective. Integrated systems are also generally unlikely to be cost-effective given that stand-alone systems are cheaper and, possibly, no less effective. However, evidence in this regard is generally lacking, in particular for children. Future trials in specific child, adolescent and adult populations should include longer term follow-up and ratings on the European Quality of Life-5 Dimensions scale at various time points with a view to informing improved cost-effectiveness modelling. PROSPERO Registration Number CRD42014013764. The National Institute for Health Research Health Technology Assessment programme.
- Research Article
9
- 10.1089/dia.2023.2511
- Feb 1, 2023
- Diabetes Technology & Therapeutics
Real-World Diabetes Technology: Overcoming Barriers and Disparities.
- Research Article
- 10.54254/2753-8818/2025.pj24464
- Jun 27, 2025
- Theoretical and Natural Science
Diabetes is a chronic and incurable metabolic disorder, necessitating rigorous blood glucose management as the cornerstone of effective treatment. Maintaining blood glucose levels within the normal range is critical for mitigating the risk of microvascular complications. Continuous glucose monitoring (CGM) systems represent a transformative advancement in glucose monitoring technology, enabling automated, real-time tracking of glycemic fluctuations by measuring interstitial fluid (ISF) glucose concentrations and converting these readings into blood glucose values.This paper provides a comprehensive overview of the development of CGM systems, reviewing their functional characteristics, target populations, and current technological advancements. Additionally, it examines the clinical evaluation framework for CGM systems and analyzes their application across diverse scenarios. Finally, the study highlights future directions and challenges in CGM technology, offering insights to guide further innovation and optimize clinical implementation.This review aims to serve as a valuable reference for researchers and clinicians in advancing next-generation CGM systems and enhancing their practical utility in diabetes management.
- Research Article
61
- 10.1089/152091503322526996
- Oct 1, 2003
- Diabetes technology & therapeutics
The accuracy of the GlucoWatch G2 Biographer (GW2B; Cygnus, Inc., Redwood City, CA) was assessed in children and adolescents with type 1 diabetes mellitus (T1DM). During a 24-h clinical research center stay, 89 children and adolescents with T1DM (3.5-17.7 years old) wore 174 GW2Bs and had frequent serum glucose determinations during the day and night and during insulin-induced hypoglycemia and meal-induced hyperglycemia, resulting in 3672 GW2B-reference glucose pairs. The median relative absolute difference between the GW2B and reference glucose values was 16% (25th, 75th percentiles = 7%, 29%). The proposed International Organisation for Standardisation criteria were met for 60% of sensor values. Accuracy was better at higher serum glucose levels than low glucose levels. Accuracy degraded slightly as the sensor aged. Time of day, subject age, gender, or body mass index did not impact GW2B accuracy. There were no cases of serious skin reactions. Although the accuracy of this generation of sensor does not approach that of current home glucose meters, the majority of sensor glucose values are within 20% of the serum glucose. This level of accuracy may be sufficient for detecting trends and modifying diabetes management. Further longitudinal outpatient studies are needed to assess the utility of the GW2B as a management tool to improve glycemic control and decrease the incidence of severe hypoglycemia in children with diabetes.
- Research Article
2
- 10.2337/db18-13-or
- Jun 22, 2018
- Diabetes
Background: An implantable continuous glucose monitoring (CGM) system (Eversense® XL, Senseonics, Maryland U.S.A) recently received CE Mark for 180-day duration in adults. The current study is the first investigation of the performance of the Eversense XL through 180 days in a primarily adolescent population with type I diabetes (T1D). Methods: This study was a prospective, single-center, single-arm, 180-day evaluation of the effectiveness and safety of the implantable CGM system among Canadian adolescent and adult participants with T1D. Effectiveness measures included mean absolute relative difference (MARD), system agreement with Yellow Springs Instrument (YSI) glucose values, and Clarke Error Grid analysis using paired CGM and reference YSI glucose analyzer values. Adult participants were inserted with two sensors and adolescent participants were inserted with one sensor in the upper arm. CGM system accuracy studies were performed every 30 days. The safety assessment included the incidence of insertion or removal procedure-related and device-related serious adverse events (SAEs) through 180 days post-insertion. Results: Thirty-Six participants (30 adolescent/6 adult, 13 female/23 male, mean age 17±9.2 years, mean BMI 22±4 kg/m2) received the CGM system. One subject withdrew at Day 1 due to intravenous access issues. CGM system agreement with YSI glucose within 15 mg/dL or 15% of YSI glucose values (N = 7163) through 60, 120 and 180 days was 82.9% (95% CI: 78.4%-86.1%), 83.6% (95% CI: 80.4%-85.7%) and 83.4% (95% CI: 79.7%-85.5%), respectively. Overall MARD was 9.4% (95% CI: 8.6%-10.5%). Clarke Error Grid analysis showed 99% of paired values in clinically acceptable error zones A and B. No insertion/removal or device-related SAEs were reported. Conclusions: The Eversense XL CGM system is safe and accurate through 180 days of Sensor wear in a primarily adolescent population. Disclosure R. Aronson: Other Relationship; Self; Novo Nordisk Inc., Janssen Pharmaceuticals, Inc., Sanofi, AstraZeneca. Research Support; Self; Eli Lilly and Company, Becton, Dickinson and Company, Merck & Co., Inc., Senseonics, Boehringer Ingelheim Pharmaceuticals, Inc. R. Rastogi: Employee; Self; Senseonics. C. Mdingi: Employee; Self; Senseonics. X. Chen: Employee; Self; Senseonics. K. Tweden: Employee; Self; Senseonics.
- Research Article
3
- 10.1111/dme.15500
- Dec 15, 2024
- Diabetic medicine : a journal of the British Diabetic Association
This expert consensus reviews the reality of primary care clinical management of people with type 2 diabetes (T2D) on non-intensive insulin therapy, with an emphasis on the use of continuous glucose monitoring (CGM) technology for effective care in this participant group. Here, we identify key unmet needs for skills and systems development within this frontline healthcare setting, along with major challenges and opportunities associated with managing these changes effectively. The authors participated in two primary care consensus panels held on 28 November 2023 and on 21 May 2024. The focus for these expert panels was to understand the unmet needs within primary care to manage adults with T2D treated with non-intensive insulin therapy and incorporating the use of CGM systems. A Delphi Survey was undertaken among a wider group of Primary Care Diabetes Technology Network members in the United Kingdom, to understand prevalent attitudes to management of adults with T2D on insulin and using CGM in primary care. Based on these activities, a series of consensus statements were tested in a second Delphi Survey. The activities described, involving primary care healthcare professionals (HCPs) with expertise in diabetes management, identified a series of training and educational needs within UK general practice that are central to skills development for the care of adults with T2D on insulin therapy and the application of CGM technology. Potential barriers to effective primary care management of people with T2D using CGM devices were identified. Areas of concern included confidence in national and local guidelines for the management of T2D using CGM systems, lack of experience on the part both of HCPs and people with T2D, clinical workflows and systems, as well as inbuilt resistance to change among primary care teams. However, the expert group were clear that the goal of providing care for people with T2D on non-intensive insulin therapy using CGM technology as standard of care could be met (94.3%, n = 33). This will deliver clinical benefits for people with T2D, and improvements to clinical workflows in primary care. Cost-savings to the health service were also identified as an outcome. The need to adapt to the management of people with T2D on insulin therapy puts significant pressure on current workflows and skills for primary care teams. Steps in overcoming these immediate pressures, to ensure effective clinical management of people with T2D, are discussed, along with a series of consensus statements that identify the key areas of change to manage. Ultimately, the great majority of expert primary care HCPs were confident or very confident that using CGM technology will become the standard of care for people with T2D treated with insulin in primary care.
- Research Article
31
- 10.1177/193229681300700405
- Jul 1, 2013
- Journal of Diabetes Science and Technology
This study aimed at evaluating and comparing the performance of a new generation of continuous glucose monitoring (CGM) system versus other CGM systems, under daily lifelike conditions. A total of 10 subjects (7 female) were enrolled in this study. Each subject wore two Dexcom G4™ CGM systems in parallel for the sensor lifetime specified by the manufacturer (7 days) to allow assessment of sensor-to-sensor precision. Capillary blood glucose (BG) measurements were performed at least once per hour during daytime and once at night. Glucose excursions were induced on two occasions. Performance was assessed by calculating the mean absolute relative difference (MARD) between CGM readings and paired capillary BG readings and precision absolute relative difference (PARD), i.e., differences between paired CGM readings. Overall aggregate MARD was 11.0% (n = 2392). Aggregate MARD for BG <70 mg/dl was 13.7%; for BG between 70 and 180 mg/dl, MARD was 11.4%; and for BG >180 mg/dl, MARD was 8.5%. Aggregate PARD was 7.3%, improving from 11.6% on day 1 to 5.2% on day 7. The Dexcom G4 CGM system showed good overall MARD compared with results reported for other commercially available CGM systems. In the hypoglycemic range, where CGM performance is often reported to be low, the Dexcom G4 CGM system achieved better MARD than that reported for other CGM systems in the hypoglycemic range. In the hyperglycemic range, the MARD was comparable to that reported for other CGM systems, whereas during induced glucose excursions, the MARD was similar or slightly worse than that reported for other CGM systems. Overall PARD was 7.3%, improving markedly with sensor life time.
- Research Article
- 10.3390/jcm15031097
- Jan 30, 2026
- Journal of clinical medicine
Background/Objectives: Migraine and diabetes mellitus are highly prevalent chronic diseases, and their comorbidity presents management challenges, particularly when wearable medical technologies are used concurrently. Remote electrical neuromodulation (REN; Nerivio®) is an FDA-cleared non-pharmacological migraine therapy, and continuous glucose monitoring (CGM) systems are widely used in diabetes care. However, the safety and compatibility of simultaneous co-use have not yet been evaluated. This technical compatibility study aimed to assess whether REN operation affects CGM performance or interferes with glucose measurement integrity in diabetic adults. Methods: Twenty-one adults with diabetes using Dexcom G6/G7 or FreeStyle Libre 2/3 participated in a single-arm interventional study. During a 45 min session, participants operated the REN and CGM devices simultaneously on their smartphones, and the REN device was paused three times to compare CGM readings between REN ON and RED OFF conditions. The primary outcome was the mean absolute relative difference (MARDREN ON/OFF), evaluated against a prespecified 5% threshold. Statistical analysis included the Wilcoxon test, with subgroup analysis by the CGM device family. Results: The median MARDREN ON/OFF across all participants was 1.61% (IQR 0.84-2.44%), significantly below the 5% threshold (p < 0.001). All participants achieved MARDREN ON/OFF < 5%. Subgroup analyses were consistent: the median MARDREN ON/OFF was 1.70% (IQR 0.90-2.45%) for Dexcom and 1.05% (IQR 0.83-1.50%) for Abbott. No technical interference, Bluetooth disruptions, missed data transmission, or adverse events were observed. Conclusions: Simultaneous use of Nerivio® REN and CGM systems in adults with diabetes is compatible and safe, with no evidence of interference or significant deviations in glucose readings. These findings support the integrated and reliable use of REN and CGM wearables in adults with diabetes managing comorbid conditions.
- Research Article
281
- 10.1002/14651858.cd008101.pub2
- Jan 18, 2012
- The Cochrane database of systematic reviews
Self-monitoring of blood glucose is essential to optimise glycaemic control in type 1 diabetes mellitus. Continuous glucose monitoring (CGM) systems measure interstitial fluid glucose levels to provide semi-continuous information about glucose levels, which identifies fluctuations that would not have been identified with conventional self-monitoring. Two types of CGM systems can be defined: retrospective systems and real-time systems. Real-time systems continuously provide the actual glucose concentration on a display. Currently, the use of CGM is not common practice and its reimbursement status is a point of debate in many countries. To assess the effects of CGM systems compared to conventional self-monitoring of blood glucose (SMBG) in patients with diabetes mellitus type 1. We searched The Cochrane Library, MEDLINE, EMBASE and CINAHL for the identification of studies. Last search date was June 8, 2011. Randomised controlled trials (RCTs) comparing retrospective or real-time CGM with conventional self-monitoring of blood glucose levels or with another type of CGM system in patients with type 1 diabetes mellitus. Primary outcomes were glycaemic control, e.g. level of glycosylated haemoglobin A1c (HbA1c) and health-related quality of life. Secondary outcomes were adverse events and complications, CGM derived glycaemic control, death and costs. Two authors independently selected the studies, assessed the risk of bias and performed data-extraction. Although there was clinical and methodological heterogeneity between studies an exploratory meta-analysis was performed on those outcomes the authors felt could be pooled without losing clinical merit. The search identified 1366 references. Twenty-two RCTs meeting the inclusion criteria of this review were identified. The results of the meta-analyses (across all age groups) indicate benefit of CGM for patients starting on CGM sensor augmented insulin pump therapy compared to patients using multiple daily injections of insulin (MDI) and standard monitoring blood glucose (SMBG). After six months there was a significant larger decline in HbA1c level for real-time CGM users starting insulin pump therapy compared to patients using MDI and SMBG (mean difference (MD) in change in HbA1c level -0.7%, 95% confidence interval (CI) -0.8% to -0.5%, 2 RCTs, 562 patients, I(2)=84%). The risk of hypoglycaemia was increased for CGM users, but CIs were wide and included unity (4/43 versus 1/35; RR 3.26, 95% CI 0.38 to 27.82 and 21/247 versus 17/248; RR 1.24, 95% CI 0.67 to 2.29). One study reported the occurrence of ketoacidosis from baseline to six months; there was however only one event. Both RCTs were in patients with poorly controlled diabetes.For patients starting with CGM only, the average decline in HbA1c level six months after baseline was also statistically significantly larger for CGM users compared to SMBG users, but much smaller than for patients starting using an insulin pump and CGM at the same time (MD change in HbA1c level -0.2%, 95% CI -0.4% to -0.1%, 6 RCTs, 963 patients, I(2)=55%). On average, there was no significant difference in risk of severe hypoglycaemia or ketoacidosis between CGM and SMBG users. The confidence interval however, was wide and included a decreased as well as an increased risk for CGM users compared to the control group (severe hypoglycaemia: 36/411 versus 33/407; RR 1.02, 95% CI 0.65 to 1.62, 4 RCTs, I(2)=0% and ketoacidosis: 8/411 versus 8/407; RR 0.94, 95% CI 0.36 to 2.40, 4 RCTs, I(2)=0%).Health-related quality of life was reported in five of the 22 studies. In none of these studies a significant difference between CGM and SMBG was found. Diabetes complications, death and costs were not measured.There were no studies in pregnant women with diabetes type 1 and in patients with hypoglycaemia unawareness. There is limited evidence for the effectiveness of real-time continuous glucose monitoring (CGM) use in children, adults and patients with poorly controlled diabetes. The largest improvements in glycaemic control were seen for sensor-augmented insulin pump therapy in patients with poorly controlled diabetes who had not used an insulin pump before. The risk of severe hypoglycaemia or ketoacidosis was not significantly increased for CGM users, but as these events occurred infrequent these results have to be interpreted cautiously.There are indications that higher compliance of wearing the CGM device improves glycosylated haemoglobin A1c level (HbA1c) to a larger extent.
- Front Matter
- 10.1111/1753-0407.13413
- May 22, 2023
- Journal of Diabetes
How can we reach the target of glucose control in type 1 diabetes?
- Research Article
7
- 10.1002/jac5.1295
- Aug 3, 2020
- JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY
Adoption of continuous glucose monitoring (CGM) technology in clinical practice has increased over the past few years with numerous studies demonstrating its benefit in persons with diabetes. In addition, the use of CGM systems is now recommended in multiple guidelines for diabetes care. Implementation of personal‐ and professional‐use CGM technology can facilitate patient‐centered discussions in clinical decision making and empower behavioral change. Pharmacists can incorporate CGM into diabetes management practices to help optimize therapy and overcome therapeutic inertia. This “how to” guide is written for pharmacists who are interested in integrating CGM into their clinical practice to improve care for those living with diabetes. It provides an overview of the different CGM systems available and describes the differences between personal‐ and professional‐use CGM to facilitate decision making for use in clinical practice. It also discusses considerations for use, candidates for coverage, billing for CGM services, data interpretation, and documentation. Lessons learned and advice for implementing into clinical practice are also provided.
- Front Matter
32
- 10.1111/1753-0407.12590
- Sep 13, 2017
- Journal of Diabetes
It can scarcely be denied that the supreme goal of all theory is to make the irreducible basic elements as simple and as few as possible without having to surrender the adequate representation of a single datum of experience. The diaTribe Foundation convened a meeting on the topic of glycemic outcomes beyond HbA1c on 21 July 2017, in Bethesda (MD, USA), focusing on potential uses of continuous glucose monitoring (CGM). Understanding patterns of glycemia in people with diabetes has long been a focus of approaches to improving treatment, and over the past few years this has become an available modality for clinical practice. Glucose levels are not the only biologic parameters affecting HbA1c levels; HbA1c changes with anemia or, more subtly, with changes in rates of erythrocyte turnover not reflected in hemoglobin levels outside the normal range. Renal disease often is associated with lower HbA1c than would be predicted based on an individual's glycemic levels. Furthermore, HbA1c levels tend to increase with age and are higher in some ethnic groups; for example, people of African ethnicity have higher HbA1c levels than people of Northern European descent. Indeed, we have argued that even as a measure of mean glycemia HbA1c is inherently imprecise. Overall, for some 20% of people with diabetes, HbA1c levels are substantially higher, or substantially lower, than those that would be predicted from mean blood glucose levels. If one recognizes that HbA1c is, at best, a partial measure of mean glycemic exposure, one must surely accept that HbA1c does not reflect variability within a day, from day to day, and from period to period. Many glucose-lowering medicines, particularly the sulfonylureas and insulin, cause hypoglycemia, with consequent negative effects on quality of life and patient-reported outcomes, as well as association with weight gain and adverse macrovascular outcome; hypoglycemia will, of course, not be captured by HbA1c measurement. Based on these considerations, HbA1c may be more limited than generally recognized as a surrogate marker of optimal diabetes treatment, leading the European Medicines Agency to consider relying less on this measure, with the implication that novel approaches will be required for clinical practice and for clinical trials in developing future medicines. In surveys performed by a market research company (dQ&A Market Research, San Francisco, CA, USA) and reported at the Bethesda meeting, among >3000 people with type 1 (T1D) or type 2 (T2D) diabetes both receiving and not receiving insulin, the majority reported a sense that their diabetes care is not very successful and that too much of their time was spent outside the 70-180 mg/dL (3.9-10.0 mEq/L) range. Although self-monitoring of capillary blood glucose (SMBG) is an important tool for patients to use in understanding glycemic excursions, CGM offers a far superior technology in this regard and can avoid the erroneous conclusions often accompanying the use of the inherently indirect measurement of HbA1c. Duration and severity of hypoglycemia may come to be considered important medication efficacy measures, rather than just being considered safety outcomes. Glucose cut-off levels suggested at the meeting may be: <54 mg/dL (3.0 mEq/L) for severe hypoglycemia, <70 mg/dL (3.9 mEq/L) for low blood glucose levels, >180 mg/dL (10.0 mEq/L) for high blood glucose levels, and >240 mg/dL (13.3 mEq/L) for serious high blood glucose levels. An important part of both SMBG and CGM technologies will be the development of data transmission and storage modalities to better provide feedback to people with diabetes and health care providers in adjusting a variety of treatments, as well as their growing use in insulin dose adjustment algorithms; important in such approaches will be the integration of SMBG with CGM to recognize potential measurement errors and to improve the accuracy and assurance of patients and providers that the CGM results are accurate, a particular concern for readings in the hypoglycemia range, but remaining an issue throughout the clinical glycemia range. However, one must recognize that many commercially available SMBG instruments also fail to exhibit required accuracy, and that the indirect relationship between HbA1c and blood glucose suggests that HbA1c is at best limited in its portrayal of glycemic exposure. All these modalities play a role, but the use of CGM appears crucial to the development of better approaches to clinical treatment with multiple views allowing understanding of patterns of glycemic exposure. We look forward to further improvements in this methodology.
- Research Article
33
- 10.1089/15209150050214096
- Dec 1, 2000
- Diabetes Technology & Therapeutics
Diabetes Technology & TherapeuticsVol. 2, No. supplement 1 Orginal ArticlesContinuous Glucose Monitoring in Previously Unstudied Population SubgroupsTodd M. Gross and Anna ter VeerTodd M. GrossSearch for more papers by this author and Anna ter VeerSearch for more papers by this authorPublished Online:5 Jul 2004https://doi.org/10.1089/15209150050214096AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byA Standard Approach to Continuous Glucose Monitor Data in Pregnancy for the Study of Fetal Growth and Infant Outcomes Teri L. Hernandez and Linda A. Barbour29 January 2013 | Diabetes Technology & Therapeutics, Vol. 15, No. 2Continuous Glucose Monitoring in Pregnancy: New Frontiers in Clinical Applications and Research1 November 2012 | Journal of Diabetes Science and Technology, Vol. 6, No. 6The Correlation and Accuracy of Glucose Levels between Interstitial Fluid and Venous Plasma by Continuous Glucose Monitoring SystemKorean Diabetes Journal, Vol. 34, No. 6Continuous Glucose Monitoring System in Free-Living Healthy Subjects: Results from a Pilot Study Giuseppe Derosa, Sibilla A.T. Salvadeo, Roberto Mereu, Angela D'Angelo, Leonardina Ciccarelli, Mario N. Piccinni, Ilaria Ferrari, Alessia Gravina, Pamela Maffioli, and Carmine Tinelli6 March 2009 | Diabetes Technology & Therapeutics, Vol. 11, No. 3Preclinical In Vivo Study of a Fluorescence Affinity Sensor for Short-Term Continuous Glucose Monitoring in a Small and Large Animal Model Ralph Dutt-Ballerstadt, Colton Evans, Ashok Gowda, and Roger McNichols13 September 2010 | Diabetes Technology & Therapeutics, Vol. 10, No. 6How to Assess and Compare the Accuracy of Continuous Glucose Monitors? I.M.E. Wentholt, A.A.M. Hart, J.B.L. Hoekstra, and J.H. DeVries8 February 2008 | Diabetes Technology & Therapeutics, Vol. 10, No. 2Future Management Approaches12 July 2013Accuracy of continuous nocturnal glucose monitoring after 48 and 72 hours in type 2 diabetes patients on combined oral and insulin therapyDiabetes & Metabolism, Vol. 30, No. 6Nocturnal hypoglycaemia in type 1 diabetes?consequences and assessment1 January 2004 | Diabetes/Metabolism Research and Reviews, Vol. 20, No. S2The Continuous Glucose Monitoring System During Pregnancy of Women with Type 1 Diabetes Mellitus: Accuracy Assessment Anneloes Kerssen, Harold W. De Valk, and Gerard H.A. Visser12 October 2004 | Diabetes Technology & Therapeutics, Vol. 6, No. 5The Public Health Impact of the MiniMed Continuous Glucose Monitoring System (CGMS®)—An Assessment of the Literature Dale R. Tavris and Azadeh Shoaibi25 August 2004 | Diabetes Technology & Therapeutics, Vol. 6, No. 4Experience with the Continuous Glucose Monitoring System® in a Medical Intensive Care Unit Philip A. Goldberg, Mark D. Siegel, Raymond R. Russell, Robert S. Sherwin, Joshua I. Halickman, Dawn A. Cooper, James D. Dziura, and Silvio E. Inzucchi5 July 2004 | Diabetes Technology & Therapeutics, Vol. 6, No. 3Glucose sensors: toward closed loop insulin deliveryEndocrinology and Metabolism Clinics of North America, Vol. 33, No. 1Enregistrement de la glycémie en continu : quelles retombées ?Annales d'Endocrinologie, Vol. 65Performance assessment of the Medtronic-MiniMed Continuous Glucose Monitoring System and its use for measurement of glycaemic control in Type 1 diabetic subjectsDiabetic Medicine, Vol. 20, No. 12The Accuracy of the CGMS™ in Children with Type 1 Diabetes: Results of the Diabetes Research in Children Network (DirecNet) Accuracy Study5 July 2004 | Diabetes Technology & Therapeutics, Vol. 5, No. 5Accuracy of the continuous glucose monitoring system in inpatient and outpatient conditionsDiabetes & Metabolism, Vol. 29, No. 2Clinical Performance of CGMS in Type 1 Diabetic Patients Treated by Continuous Subcutaneous Insulin Infusion Using Insulin AnalogsDiabetes Care, Vol. 26, No. 3Biosensors for in vivo glucose measurement: can we cross the experimental stageBiosensors and Bioelectronics, Vol. 17, No. 11-12Reproducibility of Glucose Measurements Using the Glucose SensorDiabetes Care, Vol. 25, No. 7Continuous Monitoring of the Subcutaneous Glucose Level in Freely Moving Normal and Diabetic Rats and in Humans with Type 1 Diabetes Reza Jamali, Johnny Ludvigsson, and Simin Mohseni5 July 2004 | Diabetes Technology & Therapeutics, Vol. 4, No. 3What's ahead in glucose monitoring?30 June 2015 | Postgraduate Medicine, Vol. 109, No. 4New technologies and therapeutic approaches for the management of pediatric diabetesCurrent Diabetes Reports, Vol. 1, No. 1 Volume 2Issue supplement 1Dec 2000 To cite this article:Todd M. Gross and Anna ter Veer.Continuous Glucose Monitoring in Previously Unstudied Population Subgroups.Diabetes Technology & Therapeutics.Dec 2000.27-34.http://doi.org/10.1089/15209150050214096Published in Volume: 2 Issue supplement 1: July 5, 2004PDF download
- Front Matter
2
- 10.1016/j.jcjd.2015.04.003
- Apr 28, 2015
- Canadian Journal of Diabetes
Diabetes technology and devices transform the lives of people with diabetes.