scholarly journals Continuous Glucose Monitoring (CGM) or Blood Glucose Monitoring (BGM): Interactions and Implications

2018 ◽  
Vol 12 (4) ◽  
pp. 873-879 ◽  
Author(s):  
Lutz Heinemann
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Patient Management ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Advanced Technologies ◽  
Patients With Diabetes ◽  
The Impact ◽  
Annual International Conference

At the 2017 10th annual International Conference on Advanced Technologies and Treatments for Diabetes (ATTD) in Paris, France, four speakers presented their perspectives on the roles of continuous glucose monitoring (CGM) and of blood glucose monitoring (BGM) in patient management within one symposium. These presentations included discussions of the differences in the accuracy of CGM and BGM, a clinical perspective on the physiological reasons behind differences in CGM and BGM values, and an overview of the impact of variations in device accuracy on patients with diabetes. Subsequently a short summary of these presentations is given, highlighting the value of good accuracy of BGM or CGM systems and the ongoing need for standardization. The important role of both BGM and CGM in patient management was a theme across all presentations.

scholarly journals Measures of Accuracy for Continuous Glucose Monitoring and Blood Glucose Monitoring Devices

2018 ◽  
Vol 13 (3) ◽  
pp. 575-583 ◽  
Author(s):  
Guido Freckmann ◽  
Stefan Pleus ◽  
Mike Grady ◽  
Steven Setford ◽  
Brian Levy
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Measurement Accuracy ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Glucose Measurement ◽  
Bias Analysis ◽  
Patients With Diabetes ◽  
Monitoring Devices ◽  
Error Grid

Currently, patients with diabetes may choose between two major types of system for glucose measurement: blood glucose monitoring (BGM) systems measuring glucose within capillary blood and continuous glucose monitoring (CGM) systems measuring glucose within interstitial fluid. Although BGM and CGM systems offer different functionality, both types of system are intended to help users achieve improved glucose control. Another area in which BGM and CGM systems differ is measurement accuracy. In the literature, BGM system accuracy is assessed mainly according to ISO 15197:2013 accuracy requirements, whereas CGM accuracy has hitherto mainly been assessed by MARD, although often results from additional analyses such as bias analysis or error grid analysis are provided. The intention of this review is to provide a comparison of different approaches used to determine the accuracy of BGM and CGM systems and factors that should be considered when using these different measures of accuracy to make comparisons between the analytical performance (ie, accuracy) of BGM and CGM systems. In addition, real-world implications of accuracy and its relevance are discussed.

scholarly journals Continuous Glucose Monitoring in Critically Ill Patients With COVID-19: Results of an Emergent Pilot Study

2020 ◽  
Vol 14 (6) ◽  
pp. 1065-1073
Author(s):  
Archana R. Sadhu ◽  
Ivan Alexander Serrano ◽  
Jiaqiong Xu ◽  
Tariq Nisar ◽  
Jessica Lucier ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Pilot Study ◽  
Insulin Therapy ◽  
Critically Ill ◽  
Continuous Glucose Monitoring ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Target Range

Background: Amidst the coronavirus disease 2019 (COVID-19) pandemic, continuous glucose monitoring (CGM) has emerged as an alternative for inpatient point-of-care blood glucose (POC-BG) monitoring. We performed a feasibility pilot study using CGM in critically ill patients with COVID-19 in the intensive care unit (ICU). Methods: Single-center, retrospective study of glucose monitoring in critically ill patients with COVID-19 on insulin therapy using Medtronic Guardian Connect and Dexcom G6 CGM systems. Primary outcomes were feasibility and accuracy for trending POC-BG. Secondary outcomes included reliability and nurse acceptance. Sensor glucose (SG) was used for trends between POC-BG with nursing guidance to reduce POC-BG frequency from one to two hours to four hours when the SG was in the target range. Mean absolute relative difference (MARD), Clarke error grids analysis (EGA), and Bland-Altman (B&A) plots were calculated for accuracy of paired SG and POC-BG measurements. Results: CGM devices were placed on 11 patients: Medtronic ( n = 6) and Dexcom G6 ( n = 5). Both systems were feasible and reliable with good nurse acceptance. To determine accuracy, 437 paired SG and POC-BG readings were analyzed. For Medtronic, the MARD was 13.1% with 100% of readings in zones A and B on Clarke EGA. For Dexcom, MARD was 11.1% with 98% of readings in zones A and B. B&A plots had a mean bias of −17.76 mg/dL (Medtronic) and −1.94 mg/dL (Dexcom), with wide 95% limits of agreement. Conclusions: During the COVID-19 pandemic, CGM is feasible in critically ill patients and has acceptable accuracy to identify trends and guide intermittent blood glucose monitoring with insulin therapy.

scholarly journals VP184 A Cost Analysis Of Flash Glucose Monitoring Systems In Veneto Region

2017 ◽  
Vol 33 (S1) ◽  
pp. 235-236
Author(s):  
Alessandro Curto ◽  
Marika Torbol ◽  
Anna Cavazzana ◽  
Margherita Andretta ◽  
Giovanna Scroccaro
Keyword(s):  
Blood Glucose ◽  
Cost Analysis ◽  
New Technology ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Veneto Region ◽  
Glucose Levels ◽  
Medical App ◽  
The Impact

INTRODUCTION:A novel, sensor-based, factory-calibrated Flash Monitoring System (FMS) has recently proved to be an effective alternative to conventional self-monitoring of blood glucose (SMBG) in patients affected by type 1 and type 2 diabetes. The 14-days adhesive sensor, that continuously measures glucose levels in the interstitial fluid, can transfer glucose levels data to a handheld reader or a smartphone equipped with a specific medical app. The uptake of the new technology has been limited so far, because of its high costs. A cost analysis has been conducted to identify the optimal target population of introducing FSM in Veneto.METHODS:The model was designed with a 1-year time horizon for patients with diabetes using intensive insulin in Veneto region. The costs of the new technology was estimated using inputs from the two main randomized controlled trials (the IMPACT study and the REPLACE study) published in the international literature, Regional evidence-based guidelines and administrative database. Resource utilization included strips, lancets, needles, sensors, distribution and patients training. Regional unit costs were adopted.RESULTS:FSM has not shown so far relevant and statically significant benefits in terms of severe adverse events’ reduction. Estimated yearly costs for a FSM user included glucose monitoring, technology training and distribution costs, for a total of EUR1277 per patient. The new technology has been shown to be affordable in diabetic patients with i) 4years<age<18years, ii) continuous subcutaneous insulin infusion and iii) ≥5 blood glucose monitoring per day.CONCLUSIONS:The Veneto Region should carefully consider prescribing extension to other diabetic patients categories, since the high cost of the new technology. A strict prescribing monitoring is strongly recommended with the aim of ensuring appropriateness and avoiding overspending.

Asthma and the role of blood glucose monitoring

2016 ◽  
Author(s):  
Rebecca Wollerton ◽  
Kate Millington ◽  
Rachel Jones ◽  
Ari Manuel
Keyword(s):  
Blood Glucose ◽  
Glucose Monitoring ◽  
Blood Glucose Monitoring
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