scholarly journals A Position Statement of the Utilization and Support Status of Continuous Glucose Monitoring in Korea

2021 ◽  
Vol 22 (4) ◽  
pp. 225-237
Author(s):  
Won Jun Kim ◽  
Jae Hyun Kim ◽  
Hye Jin Yoo ◽  
Jang Won Son ◽  
Ah Reum Khang ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Insurance Coverage ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Insulin Injection ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Oral Hypoglycemic Agents

The accuracy and convenience of continuous glucose monitoring (CGM), which efficiently evaluates glycemic variability and hypoglycemia, are improving. There are two types of CGM: professional CGM and personal CGM. Personal CGM is subdivided into real-time CGM (rt-CGM) and intermittently scanned CGM (isCGM). CGM is being emphasized in both domestic and foreign diabetes management guidelines. Regardless of age or type of diabetes, CGM is useful for diabetic patients undergoing multiple insulin injection therapy or using an insulin pump. rt-CGM is recommended for all adults with type 1 diabetes (T1D), and can also be used in type 2 diabetes (T2D) treatments using multiple insulin injections. In some cases, short-term or intermittent use of CGM may be helpful for patients with T2D who use insulin therapy other than multiple insulin injections and/or oral hypoglycemic agents. CGM can help to achieve A1C targets in diabetes patients during pregnancy. CGM is a safe and cost-effective alternative to self-monitoring blood glucose in T1D and some T2D patients. CGM used in diabetes management works optimally with proper education, training, and follow up. To achieve the activation of CGM and its associated benefits, it is necessary to secure sufficient repetitive training and time for data analysis, management, and education. Various supports such as compensation, insurance coverage expansion, and reimbursement are required to increase the effectiveness of CGM while considering the scale of benefit recipients, policy priorities, and financial requirements.

scholarly journals Glycemic Variability Assessed by Continuous Glucose Monitoring and Short-Term Outcome in Diabetic Patients Undergoing Percutaneous Coronary Intervention: An Observational Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Annunziata Nusca ◽  
Angelo Lauria Pantano ◽  
Rosetta Melfi ◽  
Claudio Proscia ◽  
Ernesto Maddaloni ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
Troponin I ◽  
Fasting Blood Glucose ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Percutaneous Coronary

Poor glycemic control is associated with unfavorable outcome in patients undergoing percutaneous coronary intervention (PCI), irrespective of diabetes mellitus. However a complete assessment of glycemic status may not be fully described by glycated hemoglobin or fasting blood glucose levels, whereas daily glycemic fluctuations may influence cardiovascular risk and have even more deleterious effects than sustained hyperglycemia. Thus, this paper investigated the effectiveness of a continuous glucose monitoring (CGM), registering the mean level of glycemic values but also the extent of glucose excursions during coronary revascularization, in detecting periprocedural outcome such as renal or myocardial damage, assessed by serum creatinine, neutrophil gelatinase-associated lipocalin (NGAL), and troponin I levels. High glycemic variability (GV) has been associated with worse postprocedural creatinine and NGAL variations. Moreover, GV, and predominantly hypoglycemic variations, has been observed to increase in patients with periprocedural myocardial infarction. Thus, our study investigated the usefulness of CGM in the setting of PCI where an optimal glycemic control should be achieved in order to prevent complications and improve outcome.

scholarly journals Technology for Augmenting Type 1 Diabetes Mellitus Management

2019 ◽  
Vol 24 (2) ◽  
pp. 99-106
Author(s):  
Michelle Condren ◽  
Samie Sabet ◽  
Laura J. Chalmers ◽  
Taylor Saley ◽  
Jenna Hopwood
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Continuous Glucose Monitoring ◽  
Diabetes Management ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Insulin Delivery ◽  
Diabetes Mellitus Management

Type 1 diabetes mellitus has witnessed significant progress in its management over the past several decades. This review highlights technologic advancements in type 1 diabetes management. Continuous glucose monitoring systems are now available at various functionality and cost levels, addressing diverse patient needs, including a recently US Food and Drug Administration (FDA)–approved implantable continuous glucose monitoring system (CGMS). Another dimension to these state-of-the-art technologies is CGMS and insulin pump integration. These integrations have allowed for CGMS-based adjustments to basal insulin delivery rates and suspension of insulin delivery when a low blood glucose event is predicted. This review also includes a brief discussion of upcoming technologies such as patch-based CGMS and insulin-glucagon dual-hormonal delivery.

scholarly journals Impact of continuous glucose monitoring with diabetic education on glycemic variability and HbA1c

2020 ◽  
Vol 7 (8) ◽  
pp. 1220
Author(s):  
Mohan Varughese ◽  
Riju Mathew ◽  
Jessy Varghese ◽  
Cheryln Ann Chacko ◽  
Dona V. Augustine
Keyword(s):  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Therapeutic Management ◽  
Invasive Technique ◽  
Diabetic Patients ◽  
College Hospital ◽  
Patient Consent ◽  
Inpatient Settings ◽  
The Individual

Background: Continuous glucose monitoring (CGM) is an invasive technique which can be used in both outpatient and inpatient settings and can be used for assessing the glycemic variability among individuals with diabetes. It is an effective tool in diabetic management for evaluating the hypoglycemic, hyperglycemic and euglycemic events.Methods: The study was both retrospective and prospective which was conducted at Believers Church Medical College Hospital, Thiruvalla after getting approval from the institutional ethical committee and patient consent was also taken. Patients with uncontrolled diabetes and those with suspicion of hypoglycaemia were taken from the patients attending the diabetic clinic from 26 July 2017. The study duration was from 26 July 2017 to 19 October 2019 (2 years).Results: The study revealed the importance of CGM in the therapeutic management of diabetic patients by monitoring the individual patients and leading to an individualization of therapeutic regimen. It also helped to analyse the effect of each antidiabetic agent in the individual patients and thereby preventing the further occurrence of hypoglycemic and hyperglycemic stages in the individuals and will help to maintain a euglycemic stage in each individual and thus improving the patient’s quality of life.Conclusions: Hence it is concluded from this study that CGM has an important role in the better therapeutic management in diabetic patients as it helps in individualisation of therapy based on each patient in a better glycaemic control leading to a euglycemic state resulting in statistically significant HbA1c reduction.

Peritoneal dialysis – risk factor for glycemic variability assessed by continuous glucose monitoring system

2014 ◽  
Vol 21 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Simona Popa ◽  
Cristina Văduva ◽  
Maria Moţa ◽  
Eugen Moţa
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Continuous Glucose Monitoring System ◽  
Diabetic Patients ◽  
Type 2 Diabetic

Abstract Background and Aims. Peritoneal dialysis (PD) is accompanied by a multitude of factors that influence glycemic variability, and HbA1c does not detect dynamic glucose changes. In this study we wanted to assess glycemic variability, using a 72-hour continuous glucose monitoring system (CGMS), in 31 patients stratified according to the presence of type 2 diabetes and PD. Materials and Methods. The study included 31 patients (11 type 2 diabetic PD patients, 9 non diabetic PD patients and 11 type 2 diabetic patients without PD). Glycemic variability was assessed on CGM readings by: Mean Amplitude of Glycemic Excursion (MAGE), Mean of Daily Differences (MODD), Fractal Dimensions (FD), Mean Interstitial Glucose (MIG), Area Under glycemia Curve (AUC), M100, % time with glucose >180/<70 mg/dl. Results. The PD diabetic patients presented AUC, MIG and inter-day glycemic variability (MODD) significantly higher than diabetic patients without PD. In PD patients, the type of dialysis fluid in the nocturnal exchange and peritoneal membrane status did not significantly influence glycemic variability. Conclusions. CGMS is more useful than HbA1c in quantifying the metabolic imbalance of PD patients. PD induces inter-day glycemic variability and poor glycemic control, thus being a potential risk factor for chronic complications progression in diabetic patients.

Continuous glucose monitoring: data management and evaluation by patients and health care professionals – current situation and developments

2018 ◽  
Vol 42 (6) ◽  
pp. 225-233
Author(s):  
Guido Freckmann ◽  
Jochen Mende
Keyword(s):  
Health Care ◽  
Continuous Glucose Monitoring ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Diabetic Patients ◽  
Diabetes Therapy ◽  
Software Applications ◽  
Metabolic States ◽  
Specific Device

Abstract Continuous glucose monitoring (CGM) technology represents a valuable tool for diabetic patients to control and regulate their blood glucose (BG) levels and to reduce adverse metabolic states, for example, by defining glucose alarm thresholds that alert users if the glucose value crosses to an undesired range. Improvement of CGM technology is ongoing, but there are barriers which confine the usefulness of CGM systems. The utility is mainly defined by the operability of the specific device and also by the provided benefit of available CGM software solutions. In order to take best advantage of diabetes therapy, users should be adequately educated in how to use their CGM system and how to interpret the collected data. Different CGM software applications provide partially different CGM reports and statistics. The standardization of this information also would be conducive to the best possible diabetes management.

scholarly journals Spectroscopic and Clinical Aspects of Noninvasive Glucose Measurements

1999 ◽  
Vol 45 (2) ◽  
pp. 165-177 ◽  
Author(s):  
Omar S Khalil
Keyword(s):  
Diabetes Management ◽  
Insulin Pump ◽  
Glucose Monitoring ◽  
Clinical Aspects ◽  
Diabetic Patients ◽  
Detection Techniques ◽  
Measuring Devices

Abstract Frequent determination of glucose concentrations in diabetic patients is an important tool for diabetes management. This requires repetitive lancing and finger bleeding. Use of noninvasive (NI) detection techniques offers several advantages, such as the absence of pain and exposure to sharp objects and biohazard materials, the potential for increased frequency of testing, and hence, tighter control of the glucose concentrations, and the potential for a closed-loop system including a monitor and an insulin pump. These potential advantages have led to considerable interest in the commercialization of NI glucose monitoring devices. Review of the scientific, patent, and commercial literature indicates that the spectroscopic basis for NI determination of glucose is not yet well established, and attempts at commercialization may be several steps ahead of our understanding the origin and characteristics of an in vivo glucose-specific or glucose-related signal. Several technologies have potential for leading to viable measuring devices, but most of the data are based on in vitro experimentation. Because of the technical complexity of in vivo glucose measurements, this review aims at discussing the gap between the established need and current technology limitations.

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