Abstract
In people with type 1 diabetes mellitus (T1DM), obtaining good glycemic control is essential to reduce the risk of acute and chronic complications. Frequent glucose monitoring allows the adjustment of insulin therapy to improve metabolic control with near-normal blood glucose concentrations. The recent development of innovative technological devices for the management of T1DM provides new opportunities for patients and health care professionals to improve glycemic control and quality of life. Currently, in addition to traditional self-monitoring of blood glucose (SMBG) through a glucometer, there are new strategies to measure glucose levels, including the detection of interstitial glucose through Continuous Glucose Monitoring (iCGM) or Flash Glucose Monitoring (FGM). In this review, we analyze current evidence on the efficacy and safety of FGM, with a special focus on T1DM. FGM is an effective tool with great potential for the management of T1DM both in the pediatric and adult population that can help patients to improve metabolic control and quality of life. Although FGM might not be included in the development of an artificial pancreas and some models of iCGM are more accurate than FGM and preferable in some specific situations, FGM represents a cheaper and valid alternative for selected patients. In fact, FGM provides significantly more data than the intermittent results obtained by SMBG, which may not capture intervals of extreme variability or nocturnal events. With the help of a log related to insulin doses, meal intake, physical activity and stress factors, people can achieve the full benefits of FGM and work together with health care professionals to act upon the information provided by the sensor. The graphs and trends available with FGM better allow an understanding of how different factors (e.g., physical activity, diet) impact glycemic control, consequently motivating patients to take charge of their health.
Highlights
Several studies have widely demonstrated that elevated levels of glycated hemoglobin (HbA1c) lead to long-term microvascular and macrovascular complications [1,2]
Flash Glucose Monitoring (FGM) is an effective tool with great potential for the management of type 1 diabetes mellitus (T1DM) both in the pediatric and adult population that can help patients to improve metabolic control and quality of life
FGM might not be included in the development of an artificial pancreas due to the lack of connectivity with Continuous Subcutaneous Insulin Infusion (CSII), and some models of interstitial glucose through Continuous Glucose Monitoring (iCGM) are more accurate than FGM and preferable in some specific situations, FGM represents a cheaper and valid alternative for selected patients
Summary
Several studies have widely demonstrated that elevated levels of glycated hemoglobin (HbA1c) lead to long-term microvascular and macrovascular complications [1,2]. In people with type 1 diabetes mellitus (T1DM), obtaining good glycemic control is essential to reduce the risk of acute and chronic complications [1,2]. Frequent glucose monitoring allows the adjustment of insulin therapy to improve metabolic control with near-normal blood glucose concentrations [3,4,5]. The recent development of innovative technological devices for the management of T1DM provides new opportunities for patients and health care professionals to improve glycemic control and quality of life [6,7,8]. In addition to traditional self-monitoring of blood glucose (SMBG) through a glucometer, there are new strategies to measure glucose levels, including the detection of interstitial. We will analyze current evidence on the efficacy and safety of FGM, with a special focus on T1DM
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