ABCD position statement on continuous glucose monitoring: use of glucose sensing in outpatient clinical diabetes care

Hammond, P. J.; Amiel, S. A.; Dayan, Colin; Kerr, David; Pickup, J C; Shaw, Jam; Campbell, FM; Greene, S A; Hindmarsh, PC

doi:10.1002/pdi.1448

Cited by 6 publications

(5 citation statements)

References 5 publications

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“…Based on the study evidence presented, there are already consensus statements in a number of countries with regard to the indications of CGM systems. [59][60][61][62][63][64][65][66][67][68] These differ in certain aspects (see Appendix 1). The CGM working group [Working Group Diabetes Technology (AGDT)] of the German Diabetes Association regards the following indications as relevant for CGM systems in the context of treating patients with type 1 diabetes:…”

Section: Consensus Of the Continuous Glucose Monitoring Working Groupmentioning

confidence: 99%

See 1 more Smart Citation

Continuous Glucose Monitoring: Evidence and Consensus Statement for Clinical Use

Liebl

Henrichs

Heinemann

et al. 2013

J Diabetes Sci Technol

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Section: Consensus Of the Continuous Glucose Monitoring Working Groupmentioning

confidence: 99%

“…Overview of the indications of CGM that are listed in consensus statements from various countries (arranged by indication). [59][60][61][62][63][64][65][66][67][68] 1. Use of CGM indicated for "hypoglycemia" • Discrepancy between documented blood glucose values and the mean metabolic control/HbA1c value (Spain).…”

Section: Appendixmentioning

confidence: 99%

Continuous Glucose Monitoring: Evidence and Consensus Statement for Clinical Use

Liebl

Henrichs

Heinemann

et al. 2013

J Diabetes Sci Technol

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“…Actually, the indications given by some European authorities for RTCGM use vary little from country to country [40,[90][91][92][93]. In almost all documents they are differentiated between adults and children and pregnancy and pregnancy planning is considered separately; there is always a threshold of HbA 1c , although not uniform, and hypoglycemia is usually cited as a main indication if present in severe form or in case of unawareness [94].…”

Section: Characteristics Of Patients Eligible For Real-time Continuoumentioning

confidence: 99%

Real-Time Continuous Glucose Monitoring in Adult Outpatients

Bonomo¹,

Grassi²,

Bartolo³

et al. 2014

Frontiers in Diabetes

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With real-time continuous glucose monitoring (RTCGM), the patient has a continuous picture of glucose concentrations -dynamic information with important predictive value. It is in fact a typical 'patient-oriented' tool that permits a more aggressive therapeutic approach and makes it easier to adapt therapy immediately. Currently approved RTCGM devices consist of three main components: a glucose sensor, a transmitter, and a receiver monitor. The system is defined as minimally invasive because it requires insertion into the subcutaneous cellular tissue of a fine needle to measure the glucose in the interstitial fluid directly or via an external sensor. A correct selection of patients is one of the most important factors in determining a successful application of this innovative technology. For this purpose, there are already consensus statements in a number of countries with regard to the indications of these systems. The criteria for identification of candidates are usually divided into three main categories: pediatric/adolescent, adult patients (both in the general population of type 1 diabetes and in specific settings), and pregnant women or women in the preconception period. RTCGM opens up extremely interesting prospects that are destined to radically change the concept of clinical self-management of diabetes. Considering the technical progress towards overcoming the current limitations (essentially: not optimal accuracy, invasiveness, and costs) which currently prevent its widespread use, we can expect wide diffusion of this form of monitoring in the coming years.

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“…To try and provide some guidance as to when CGM should be used we produced a consensus statement on behalf of ABCD (the Association of British Clinical Diabetologists) in 20106 which summarised the indications for CGM as: Continuous use to achieve target HbA 1c when intensive insulin therapy apparently optimised. Diagnostic: – Suspected nocturnal hypoglycaemia and/or early morning hyperglycaemia – Suspected unrecognised hypoglycaemia, e.g. exceptionally low HbA 1c without reported hypoglycaemia – HbA 1c above individualised target despite intensified insulin therapy apparently optimised with self‐monitoring – Persistent disabling hypoglycaemia despite conversion from MDI to CSII. Therapeutic: – Further optimisation of pump therapy regimens when HbA 1c cannot be consistently lowered below 7.5% (58mmol/mol), or 6.1% (43mmol/mol) in pregnancy – Protection against recurrent disabling hypoglycaemia, and for those with hypoglycaemia unawareness or debilitating fear of hypoglycaemia – Need to ensure avoidance of even modest hyperglycaemia, e.g.…”

Section: Indications For Cgmmentioning

confidence: 99%

Continuous glucose monitoring: the clinical picture. How to interpret and use the data

Hammond

2012

Practical Diabetes

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There is a limited evidence base as to the benefits of continuous glucose monitoring (CGM) in clinical practice, but it is clear that in order to realise improvements in glycaemic control when using CGM there is a requirement for both health care professionals and patients to have the ability to interpret the data obtained from CGM. This article describes a personal approach to analysing CGM data using a structured approach and reporting tool, with examples to demonstrate how this system is implemented in practice. By viewing the daily overlay, then breaking the CGM traces into overnight, fasting/pre‐meal and post‐meal phases, and finally looking at the impact of other factors such as exercise, alcohol and work patterns, the user can be educated to make changes to both their insulin regimen and lifestyle to optimise glycaemic control. Those offered CGM as a real‐time adjunct to their intensive insulin regimen need to have such a structured approach to get positive re‐inforcement and thus use CGM sufficiently frequently to gain real benefit from it. Copyright © 2012 John Wiley & Sons.

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ABCD position statement on continuous glucose monitoring: use of glucose sensing in outpatient clinical diabetes care

Cited by 6 publications

References 5 publications

Continuous Glucose Monitoring: Evidence and Consensus Statement for Clinical Use

Continuous Glucose Monitoring: Evidence and Consensus Statement for Clinical Use

Real-Time Continuous Glucose Monitoring in Adult Outpatients

Continuous glucose monitoring: the clinical picture. How to interpret and use the data

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