Orienting practice staff to the use of CGM technology and downloading reports to a standalone computer and printer that are separate from restrictive administrative firewalls can streamline analysis of CGM data.Īlthough there can be some barriers to CGM use, there is also strong evidence for its utility in patients with either type 1 or type 2 diabetes and with either personal or professional CGM systems ( 11). Common issues reported include data overload, increased clinic staff time, and the need for HCP education on data interpretation ( 9, 10). Integrating CGM into clinical practice can be challenging for several reasons. Having glucose data readily available is also relevant for loved ones and caregivers of people with diabetes, allowing them to better assist in care and offering them peace of mind with regard to hypoglycemia and hyperglycemia. This opportunity facilitates increased patient engagement with diabetes management. The visual display of CGM data allows patients to view their glycemic activity and monitor the effects of different types of food, timing of meals, activity levels, stress, and illness. These trend arrows are a visual display of the direction of glycemic activity (i.e., whether the current glucose level is rising, stable, or decreasing) ( 8). The AGP visually displays the dynamics of glycemic activity, including periods of hypoglycemia, glycemic excursions (both high and low), TIR, and recurring glucose patterns, all of which are meaningful metrics for guiding comprehensive diabetes management.įrom the patient perspective, CGM offers the benefit of real-time glycemic monitoring with glucose trend information indicated by directional arrows. The abundance of data gathered via CGM can be reviewed and interpreted through the ambulatory glucose profile (AGP) report, a standardized CGM report that provides a graphical and quantitative display of glycemic activity. More specifically, such CGM has been used to evaluate the effects of various interventions, behaviors, and therapies, including the effects of foods or various types of exercise and medication titration ( 4– 7). Professional CGM systems have been used clinically to measure the effects of variables over an intermittent or specific time interval, such as 3 days or 2 weeks. Retrospective review of CGM data can reveal therapeutic impacts on glucose management, aid in making treatment decisions, and provide opportunities for education. CGM data also give HCPs insight into patients’ behaviors and glycemic patterns and may reveal previously undetected issues such as hypoglycemia ( 2, 3).
The data collected by these devices and either downloaded in the clinic or transmitted remotely allow for visualization of a patient’s true glycemic picture and the effects of current interventional treatments. HCPs may use the unblinded option to help patients increase their awareness of their own glucose levels and make real-time treatment decisions. The Dexcom G6 professional CGM system can be prescribed in blinded and unblinded modes. The data are uploaded in the HCP’s office for retrospective review with the patient.
#Cgm findings pro#
The Medtronic iPro2 and the FreeStyle Libre Pro are professional CGM systems for which data are blinded to the patient. They may prescribe a personal CGM device, which a patient can use either continuously or intermittently, or they may purchase for their practices professional CGM systems that can be sent home with a patient for a brief period of time for diagnostic purposes. Health care providers (HCPs) can implement two different modalities of CGM. CGM can be a good option for patients with inconsistent or confounding glycemic control, who desire engagement in their own disease management, or whose treatment plan puts them in danger of hypoglycemia. However, it does not capture glycemic variability thus, individuals who have the same A1C may have vastly different glucose ranges ( 2, 3). As is well known, the A1C test provides an indication of average glycemic control over the previous 2–3 months. Moreover, glucose patterns captured via CGM data analysis can highlight areas in need of treatment intervention (e.g., to prevent hypoglycemia, improve glycemic control at specific times of day, and increase overall TIR). Increased frequency of glucose monitoring is associated with decreased hypoglycemia and increased glycemic time in range (TIR), which correlates with improved A1C ( 1). The robust data garnered from CGM can also be used for detection of trends, identification of asymptomatic events, and review of glycemic variability over a range of time. Recent CGM systems have moved beyond mere blood glucose monitoring (BGM) by providing both real-time and predictive glycemic data.
Continuous glucose monitoring (CGM) systems are more than just glucose monitors.
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