Putting Continuous Glucose Monitoring to Work for People With Type 1 Diabetes.

Abstract

The recent development of reliable systems for continuously monitoring interstitial glucose levels has set the stage for a revolution in diabetes research and care. The ability to obtain real-time and summary displays of glycemic patterns of individuals with diabetes, together with rapidly obtained agreement on various definitions and ways of handling the resulting data (1,2), has led to both rapid acceptance of continuous glucose monitoring (CGM) devices and incorporation of CGM into clinical research studies. At the clinical level, some practical and quality-of-life–related benefits of CGM are well documented (3,4). Newer systems offer improved accuracy, fewer (or no) fingersticks, and remote monitoring of potentially dangerous glycemic events. While access to and use of CGM are increasing, some important questions remain. Which groups of people with diabetes will benefit the most from CGM use? When is the best time to introduce CGM systems to diabetes care? How should use of CGM systems be taught and adjusted? What specific outcomes are most critical to improve and document? How can this technology be used most cost-effectively? All members of the diabetes community—people with diabetes themselves, caregivers of persons with diabetes, diabetes care providers, payers, and health system managers—will benefit from objective data addressing all these questions. The collection of articles presented in this issue of Diabetes Care offers information on some of these questions for people with type 1 diabetes. Three reports describe CGM experiences in diverse populations. Miller et al. (5) display the recent dramatic increases in CGM use by both youth and adults with type 1 diabetes in the T1D Exchange in the U.S. (6) and the DPV (Diabetes Patienten Verlaufdocumentation) registry in Germany and Austria (7). CGM use among those <18 years old increased from <5% in 2011 to 31% in the T1D Exchange and 44% …