Role of continuous glucose monitoring in diabetes management

Continuous Glucose Monitoring (CGM) is among the most important recent advances in diabetes technology for better diabetes management. The CGM provides patients with real-time information about glucose levels, direction and rate of change, and glucose trends. There are currently four continuous glucose monitoring devices (sensors) in clinical use which measure interstitial fluid to calculate blood glucose levels using several algorithms. These devices include sensors developed by GlucoWatch®, DexCom™ (DexCom SEVEN® PLUS), Medtronic (MiniMed Paradigm® REAL-Time and Guardian® REAL-Time), and Abbott Diabetes Care (FreeStyle Navigator®). Continuous Glucose Monitoring is currently approved as adjunctive to Self-Monitoring of Blood Glucose (SMBG), and the CGM data should be confirmed using SMBG for treatment decisions. The use of CGM, both in research and clinical settings, has been documented to decrease blood glucose excursions, lower HbA1c values, and reduce hypoglycemic episodes, which together diminish the risk of complications associated with diabetes. In addition, use of CGM helps in reducing glucose variability. The CGM is also useful associated with special patient populations such as pregnant women with gestational diabetes or type 1 diabetes, children, and subjects with unexplained hypoglycemic unawareness, even though it is not approved by the Food and Drug Administration (FDA) for many of these special circumstances.