96
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range

      review-article
      1 , 2 , 3 , 4 , 5 , 2 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 1 , 11 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 2 , 22 , 23 , 24 , 9 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 28 , 38
      Diabetes Care
      American Diabetes Association

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Improvements in sensor accuracy, greater convenience and ease of use, and expanding reimbursement have led to growing adoption of continuous glucose monitoring (CGM). However, successful utilization of CGM technology in routine clinical practice remains relatively low. This may be due in part to the lack of clear and agreed-upon glycemic targets that both diabetes teams and people with diabetes can work toward. Although unified recommendations for use of key CGM metrics have been established in three separate peer-reviewed articles, formal adoption by diabetes professional organizations and guidance in the practical application of these metrics in clinical practice have been lacking. In February 2019, the Advanced Technologies & Treatments for Diabetes (ATTD) Congress convened an international panel of physicians, researchers, and individuals with diabetes who are expert in CGM technologies to address this issue. This article summarizes the ATTD consensus recommendations for relevant aspects of CGM data utilization and reporting among the various diabetes populations.

          Related collections

          Most cited references51

          • Record: found
          • Abstract: found
          • Article: not found

          Flash Glucose-Sensing Technology as a Replacement for Blood Glucose Monitoring for the Management of Insulin-Treated Type 2 Diabetes: a Multicenter, Open-Label Randomized Controlled Trial

          Introduction Glycemic control in participants with insulin-treated diabetes remains challenging. We assessed safety and efficacy of new flash glucose-sensing technology to replace self-monitoring of blood glucose (SMBG). Methods This open-label randomized controlled study (ClinicalTrials.gov, NCT02082184) enrolled adults with type 2 diabetes on intensive insulin therapy from 26 European diabetes centers. Following 2 weeks of blinded sensor wear, 2:1 (intervention/control) randomization (centrally, using biased-coin minimization dependant on study center and insulin administration) was to control (SMBG) or intervention (glucose-sensing technology). Participants and investigators were not masked to group allocation. Primary outcome was difference in HbA1c at 6 months in the full analysis set. Prespecified secondary outcomes included time in hypoglycemia, effect of age, and patient satisfaction. Results Participants (n = 224) were randomized (149 intervention, 75 controls). At 6 months, there was no difference in the change in HbA1c between intervention and controls: −3.1 ± 0.75 mmol/mol, [−0.29 ± 0.07% (mean ± SE)] and −3.4 ± 1.04 mmol/mol (−0.31 ± 0.09%) respectively; p = 0.8222. A difference was detected in participants aged <65 years [−5.7 ± 0.96 mmol/mol (−0.53 ± 0.09%) and −2.2 ± 1.31 mmol/mol (−0.20 ± 0.12%), respectively; p = 0.0301]. Time in hypoglycemia <3.9 mmol/L (70 mg/dL) reduced by 0.47 ± 0.13 h/day [mean ± SE (p = 0.0006)], and <3.1 mmol/L (55 mg/dL) reduced by 0.22 ± 0.07 h/day (p = 0.0014) for intervention participants compared with controls; reductions of 43% and 53%, respectively. SMBG frequency, similar at baseline, decreased in intervention participants from 3.8 ± 1.4 tests/day (mean ± SD) to 0.3 ± 0.7, remaining unchanged in controls. Treatment satisfaction was higher in intervention compared with controls (DTSQ 13.1 ± 0.50 (mean ± SE) and 9.0 ± 0.72, respectively; p < 0.0001). No serious adverse events or severe hypoglycemic events were reported related to sensor data use. Forty-two serious events [16 (10.7%) intervention participants, 12 (16.0%) controls] were not device-related. Six intervention participants reported nine adverse events for sensor-wear reactions (two severe, six moderate, one mild). Conclusion Flash glucose-sensing technology use in type 2 diabetes with intensive insulin therapy results in no difference in HbA1c change and reduced hypoglycemia, thus offering a safe, effective replacement for SMBG. Trial registration ClinicalTrials.gov identifier: NCT02082184. Funding Abbott Diabetes Care. Electronic supplementary material The online version of this article (doi:10.1007/s13300-016-0223-6) contains supplementary material, which is available to authorized users.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Association of Time in Range, as Assessed by Continuous Glucose Monitoring, With Diabetic Retinopathy in Type 2 Diabetes

            Continuous glucose monitoring (CGM) has provided new measures of glycemic control that link to diabetes complications. This study investigated the association between the time in range (TIR) assessed by CGM and diabetic retinopathy (DR).
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Continuous Glucose Monitoring Versus Usual Care in Patients With Type 2 Diabetes Receiving Multiple Daily Insulin Injections

              Continuous glucose monitoring (CGM), which studies have shown is beneficial for adults with type 1 diabetes, has not been well-evaluated in those with type 2 diabetes receiving insulin.
                Bookmark

                Author and article information

                Journal
                Diabetes Care
                Diabetes Care
                diacare
                dcare
                Diabetes Care
                Diabetes Care
                American Diabetes Association
                0149-5992
                1935-5548
                August 2019
                8 June 2019
                : 42
                : 8
                : 1593-1603
                Affiliations
                [1] 1Department of Pediatric Endocrinology, Diabetes and Metabolism, University Children’s Hospital, University Medical Centre Ljubljana, and Faculty of Medicine, University of Ljubljana, Slovenia
                [2] 2Diabetes Centre for Children and Adolescents, Kinder- und Jugendkrankenhaus Auf der Bult, Hannover, Germany
                [3] 3International Diabetes Center at Park Nicollet, Minneapolis, MN
                [4] 4Diabetes Research Group, King's College London, London, U.K.
                [5] 5Jaeb Center for Health Research, Tampa, FL
                [6] 6Diabetes Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
                [7] 7Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford Medical Center, Stanford, CA
                [8] 8American Diabetes Association, Alexandria, VA
                [9] 9Close Concerns and The diaTribe Foundation, San Francisco, CA
                [10] 10Department of Information Engineering, University of Padova, Padua, Italy
                [11] 11Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA
                [12] 12Profil, Neuss, Germany
                [13] 13Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
                [14] 14Children's Hospital at Westmead, University of Sydney, Sydney, Australia
                [15] 15University of Colorado Denver and Barbara Davis Center for Diabetes, Aurora, CO
                [16] 16Grunberger Diabetes Institute, Bloomfield Hills, MI
                [17] 17Academic Unit of Diabetes, Endocrinology and Metabolism, University of Sheffield, Sheffield, U.K.
                [18] 18Science Consulting in Diabetes, Neuss, Germany
                [19] 19Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington School of Medicine, Seattle, WA
                [20] 20Wellcome Trust-MRC Institute of Metabolic Science, and Department of Paediatrics, University of Cambridge, Cambridge, U.K.
                [21] 21Department of Endocrinology & Metabolism, Shanghai Clinical Center of Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
                [22] 22Center for Diabetes Technology, University of Virginia, Charlottesville, VA
                [23] 23JDRF, New York, NY
                [24] 24Pediatric, Adolescent and Young Adult Section and Section on Clinical, Behavioral and Outcomes Research, Joslin Diabetes Center, Harvard Medical School, Boston, MA
                [25] 25Endocrinology Research Centre, Moscow, Russia
                [26] 26Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium
                [27] 27Norwich Medical School, University of East Anglia, Norwich, U.K.
                [28] 28Jesse Z and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel
                [29] 29Steno Diabetes Center Copenhagen, Gentofte, Denmark
                [30] 30CGParkin Communications, Inc., Henderson, NV
                [31] 31Department of Endocrinology, Diabetes, and Nutrition, Montpellier University Hospital; Institute of Functional Genomics, University of Montpellier; and INSERM Clinical Investigation Centre, Montpellier, France
                [32] 32Biomedical Informatics Consultants LLC, Potomac, MD
                [33] 33DiaCare, Ahmedabad, Gujarat, India
                [34] 34Pediatric Endocrinology, University of Florida, Gainesville, FL
                [35] 35dQ&A Market Research, Inc., San Francisco, CA
                [36] 36Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan
                [37] 37Department of Pediatrics, Yale University School of Medicine, New Haven, CT
                [38] 38Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
                Author notes
                Corresponding author: Tadej Battelino, tadej.battelino@ 123456mf.uni-lj.si
                Author information
                http://orcid.org/0000-0002-0273-4732
                http://orcid.org/0000-0003-0773-6961
                http://orcid.org/0000-0002-9050-5584
                http://orcid.org/0000-0003-2686-5531
                http://orcid.org/0000-0002-5194-8446
                http://orcid.org/0000-0002-0169-6682
                http://orcid.org/0000-0001-5333-6892
                http://orcid.org/0000-0001-9196-9906
                http://orcid.org/0000-0002-3293-9114
                http://orcid.org/0000-0003-2431-0532
                http://orcid.org/0000-0002-2425-9565
                http://orcid.org/0000-0003-1675-8417
                http://orcid.org/0000-0003-2901-461X
                http://orcid.org/0000-0002-6244-2168
                http://orcid.org/0000-0003-0495-3901
                http://orcid.org/0000-0002-0979-5343
                http://orcid.org/0000-0002-9675-3001
                http://orcid.org/0000-0002-6099-2406
                http://orcid.org/0000-0001-6876-8727
                http://orcid.org/0000-0003-3571-4938
                http://orcid.org/0000-0003-1620-8271
                http://orcid.org/0000-0001-6838-5355
                http://orcid.org/0000-0002-3407-7263
                http://orcid.org/0000-0002-1044-5762
                http://orcid.org/0000-0001-7976-9557
                http://orcid.org/0000-0002-6616-5612
                Article
                0028
                10.2337/dci19-0028
                6973648
                31177185
                b4db1b49-2a9b-4ecf-b60f-6c3f43697913
                © 2019 by the American Diabetes Association.

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

                History
                Page count
                Figures: 2, Tables: 5, Equations: 0, References: 91, Pages: 11
                Categories
                0201
                International Consensus Report

                Endocrinology & Diabetes
                Endocrinology & Diabetes

                Comments

                Comment on this article