scholarly journals Glucose monitoring technologies - complementary or competitive? Role of continuous glucose monitoring versus flash glucose monitoring versus self-monitoring of blood glucose

2017 ◽  
Vol 8 (3) ◽  
pp. 61 ◽  
Author(s):  
Jothydev Kesavadev ◽  
Lakshmy Ramachandran ◽  
Gopika Krishnan
Keyword(s):  
Blood Glucose ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Self Monitoring ◽  
Flash Glucose Monitoring ◽  
Monitoring Technologies

scholarly journals Continuous glucose monitoring: review of promising technologies

2019 ◽  
Vol 252 ◽  
pp. 02012
Author(s):  
Monika Klimek ◽  
Tytus Tulwin
Keyword(s):  
Glycemic Control ◽  
Continuous Glucose Monitoring ◽  
New Technologies ◽  
Glucose Monitoring ◽  
Flash Glucose Monitoring ◽  
Uncontrolled Diabetes ◽  
Monitoring Technologies

Despite the progress we have made in the management of diabetes it is still incurable and aggravating disease affecting all domains of quality of life. Uncontrolled diabetes associated with hyperglycemia leads to serious microvascular and macrovascular long-term complications. The proper long-term glycemic control is a key strategy for preventing the development or slowing the progression of diabetes complications, thus there is a crucial role of new technologies in the diabetes care. New technologies in diabetology are developing dynamically in recent years and therefore this is a topical issue. In this paper we describe current and developing continuous glucose monitoring technologies and their usefulness in promoting optimal glycemic control, influence on personalized diabetes managements and the functioning of patients. Moreover we review knowledge about flash glucose monitoring and close-loop system. This review examines studies published before 31st August 2018.

scholarly journals Real-time continuous glucose monitoring versus self-monitoring of blood glucose in adults with insulin-treated type 2 diabetes: a protocol for a randomised controlled single-centre trial

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040648
Author(s):  
Nanna Lind ◽  
Dorte Lindqvist Hansen ◽  
Signe Sætre Rasmussen ◽  
Kirsten Nørgaard
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Peer Support ◽  
Continuous Glucose Monitoring ◽  
Data Protection ◽  
Treatment Options ◽  
Glucose Monitoring ◽  
Single Centre ◽  
Self Monitoring

IntroductionMedical treatment options for type 2 diabetes (T2D) have increased over the last decade and enhance the possibility of individualised treatment strategies where insulin is still one of them. In spite of the advancements in treatment options, less than one-third of the population with T2D obtain their optimal glycaemic goal. In persons with type 1 diabetes, continuous glucose monitoring (CGM) has shown to be the most important driver for improvement in glycaemic control, even more than insulin-pump therapy. The use of technology in T2D has only been investigated in few studies.The overall objective of the research study is to examine the effectiveness of the use of CGM versus self-monitoring of blood glucose (SMBG) in persons with insulin-treated T2D on glycaemic variables and patient-reported outcomes on treatment satisfaction, health behaviour and well-being. The independent effect of peer support will also be studied.Methods and analysisThe study is a single centre, prospective, randomised, open-labelled, three-armed study with the randomisation 2:1:2 in group A with CGM, group B with CGM and peer support, and group C as a control group with SMBG. The participants receive a training course unique for the allocation group. The study runs for 12 months and includes 100 adult participants with insulin-treated T2D, treated at the outpatient clinic at Steno Diabetes Center Copenhagen. Primary outcome is difference in change in time in range. Recruitment begins in August 2020 and ends in July 2021. Final 12-month follow-up is anticipated to be in August 2022.Ethics and disseminationThe study will be carried out in accordance with the Helsinki Declaration and is approved by the Scientific Ethics Committee of the Capital Region (H-20000843). Data collection and handling will be performed in accordance with the General Data Protection Regulation and is approved by the Danish Data Protection Agency (J-2020-100). Dissemination will be in international peer-reviewed journals, conferences and a plain-language summary for participants.Trial registration numberClinicalTrials.gov Registry (NCT04331444).Protocol versionV.3, 11 December 2020.

scholarly journals Improved HbA1c and reduced glycaemic variability after 1-year intermittent use of flash glucose monitoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wenhui Zhang ◽  
Yu Liu ◽  
Baosheng Sun ◽  
Yanjun Shen ◽  
Ming Li ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Insulin Dose ◽  
Glucose Monitoring ◽  
Final Visit ◽  
Glycaemic Variability ◽  
Self Monitoring ◽  
Flash Glucose Monitoring ◽  
Significant Difference ◽  
Mean Blood Glucose ◽  
Hba1c Measurement

AbstractFlash glucose monitoring (FGM) was introduced in China in 2016, and it might improve HbA1c measurements and reduce glycaemic variability during T1DM therapy. A total of 146 patients were recruited from October 2018 to September 2019 in Liaocheng. The patients were randomly divided into the FGM group or self-monitoring blood glucose (SMBG) group. Both groups wore the FGM device for multiple 2-week periods, beginning with the 1st, 24th, and 48th weeks for gathering data, while blood samples were also collected for HbA1c measurement. Dietary guidance and insulin dose adjustments were provided to the FGM group patients according to their Ambulatory Glucose Profile (AGP) and to the SMBG group patients according to their SMBG measurements taken 3–4 times daily. All of the participants underwent SMBG measurements on the days when not wearing the FGM device. At the final visit, HbA1c, time in range (TIR), duration of hypoglycaemia and the number of diabetic ketoacidosis (DKA) events were taken as the main endpoints. There were no significant difference in the baseline characteristics of the two groups. At 24 weeks, the HbA1c level of the FGM group was 8.16 ± 1.03%, which was much lower than that of the SMBG group (8.68 ± 1.01%) (p = 0.003). The interquartile range (IQR), mean blood glucose (MBG), and the duration of hypoglycaemia in the FGM group also showed significant declines, compared with the SMBG group (p < 0.05), while the TIR increased in the FGM group [(49.39 ± 17.54)% vs (42.44 ± 15.49)%] (p = 0.012). At 48 weeks, the differences were more pronounced (p < 0.01). There were no observed changes in the number of episodes of DKA by the end of the study [(0.25 ± 0.50) vs (0.28 ± 0.51), p = 0.75]. Intermittent use of FGM by T1DM patients can improve their HbA1c and glycaemic control without increasing the hypoglycaemic exposure in insulin-treated individuals with type 1 diabetes in an developing country.

scholarly journals Accuracy of flash glucose monitoring and continuous glucose monitoring technologies: Implications for clinical practice

2018 ◽  
Vol 15 (3) ◽  
pp. 175-184 ◽  
Author(s):  
Ramzi A Ajjan ◽  
Michael H Cummings ◽  
Peter Jennings ◽  
Lalantha Leelarathna ◽  
Gerry Rayman ◽  
...  
Keyword(s):  
Continuous Glucose Monitoring ◽  
Diabetes Care ◽  
Interstitial Fluid ◽  
Glucose Monitoring ◽  
Relative Difference ◽  
Glucose Sensing ◽  
Sensor Data ◽  
Flash Glucose Monitoring ◽  
Fluid Sensor ◽  
Monitoring Technologies

Continuous glucose monitoring and flash glucose monitoring technologies measure glucose in the interstitial fluid and are increasingly used in diabetes care. Their accuracy, key to effective glycaemic management, is usually measured using the mean absolute relative difference of the interstitial fluid sensor compared to reference blood glucose readings. However, mean absolute relative difference is not standardised and has limitations. This review aims to provide a consensus opinion on assessing accuracy of interstitial fluid glucose sensing technologies. Mean absolute relative difference is influenced by glucose distribution and rate of change; hence, we express caution on the reliability of comparing mean absolute relative difference data from different study systems and conditions. We also review the pitfalls associated with mean absolute relative difference at different glucose levels and explore additional ways of assessing accuracy of interstitial fluid devices. Importantly, much data indicate that current practice of assessing accuracy of different systems based on individualised mean absolute relative difference results has limitations, which have potential clinical implications. Healthcare professionals must understand the factors that influence mean absolute relative difference as a metric for accuracy and look at additional assessments, such as consensus error grid analysis, when evaluating continuous glucose monitoring and flash glucose monitoring systems in diabetes care. This in turn will ensure that management decisions based on interstitial fluid sensor data are both effective and safe.

scholarly journals Flash glucose monitoring helps achieve better glycemic control than conventional self-monitoring of blood glucose in non-insulin-treated type 2 diabetes: a randomized controlled trial

2020 ◽  
Vol 8 (1) ◽  
pp. e001115 ◽  
Author(s):  
Eri Wada ◽  
Takeshi Onoue ◽  
Tomoko Kobayashi ◽  
Tomoko Handa ◽  
Ayaka Hayase ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Monitoring ◽  
Analysis Of Covariance ◽  
Self Monitoring ◽  
Flash Glucose Monitoring ◽  
Baseline Values ◽  
The Mean

IntroductionThe present study aimed to evaluate the effects of flash glucose monitoring (FGM) and conventional self-monitoring of blood glucose (SMBG) on glycemic control in patients with non-insulin-treated type 2 diabetes.Research design and methodsIn this 24-week, multicenter, open-label, randomized (1:1), parallel-group study, patients with non-insulin-treated type 2 diabetes at five hospitals in Japan were randomly assigned to the FGM (n=49) or SMBG (n=51) groups and were provided each device for 12 weeks. The primary outcome was change in glycated hemoglobin (HbA1c) level, and was compared using analysis of covariance model that included baseline values and group as covariates.ResultsForty-eight participants in the FGM group and 45 in the SMBG group completed the study. The mean HbA1c levels were 7.83% (62.1 mmol/mol) in the FGM group and 7.84% (62.2 mmol/mol) in the SMBG group at baseline, and the values were reduced in both FGM (−0.43% (−4.7 mmol/mol), p<0.001) and SMBG groups (−0.30% (−3.3 mmol/mol), p=0.001) at 12 weeks. On the other hand, HbA1c was significantly decreased from baseline values in the FGM group, but not in the SMBG group at 24 weeks (FGM: −0.46% (−5.0 mmol/mol), p<0.001; SMBG: −0.17% (−1.8 mmol/mol), p=0.124); a significant between-group difference was also observed (difference −0.29% (−3.2 mmol/mol), p=0.022). Diabetes Treatment Satisfaction Questionnaire score was significantly improved, and the mean glucose levels, SD of glucose, mean amplitude of glycemic excursions and time in hyperglycemia were significantly decreased in the FGM group compared with the SMBG group.ConclusionsGlycemic control was better with FGM than with SMBG after cessation of glucose monitoring in patients with non-insulin-treated type 2 diabetes.Trial registration numberUMIN000026452, jRCTs041180082.

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