Continuous Glucose Monitoring Devices: Past, Present, and Future Focus on the History and Evolution of Technological Innovation

Didyuk, Olesya; Econom, Nicolas; Guardia, Angelica; Livingston, Kelsey; Klueh, Ulrike

doi:10.1177/1932296819899394

Cited by 79 publications

(58 citation statements)

References 46 publications

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“…With longer-duration sensors, it will be necessary to develop better adhesives that are less likely to cause a rash [ 93 ]. In order to prolong viable implantation time, it will be necessary to develop better coatings that will minimize the foreign body response that limits integration of the sensor into the subcutaneous space [ 94 ]. Future CGM data will become interconnected with multiple other data streams to provide a more nuanced pattern of how behavior affects glycemia and to better predict glucose patterns [ 95 ].…”

Section: Future Technologymentioning

confidence: 99%

Continuous Glucose Monitoring in the Hospital

et al. 2021

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Continuous glucose monitors (CGMs) have suddenly become part of routine care in many hospitals. The coronavirus disease 2019 (COVID-19) pandemic has necessitated the use of new technologies and new processes to care for hospitalized patients, including diabetes patients. The use of CGMs to automatically and remotely supplement or replace assisted monitoring of blood glucose by bedside nurses can decrease: the amount of necessary nursing exposure to COVID-19 patients with diabetes; the amount of time required for obtaining blood glucose measurements, and the amount of personal protective equipment necessary for interacting with patients during the blood glucose testing. The United States Food and Drug Administration (FDA) is now exercising enforcement discretion and not objecting to certain factory-calibrated CGMs being used in a hospital setting, both to facilitate patient care and to obtain performance data that can be used for future regulatory submissions. CGMs can be used in the hospital to decrease the frequency of fingerstick point of care capillary blood glucose testing, decrease hyperglycemic episodes, and decrease hypoglycemic episodes. Most of the research on CGMs in the hospital has focused on their accuracy and only recently outcomes data has been reported. A hospital CGM program requires cooperation of physicians, bedside nurses, diabetes educators, and hospital administrators to appropriately select and manage patients. Processes for collecting, reviewing, storing, and responding to CGM data must be established for such a program to be successful. CGM technology is advancing and we expect that CGMs will be increasingly used in the hospital for patients with diabetes.

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Section: Future Technologymentioning

confidence: 99%

Continuous Glucose Monitoring in the Hospital

et al. 2021

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“…The act of monitoring and correcting situations for hypo/hyperglycemia is imperative for delaying the onset and slowing the progression of diabetic complications in the user. 10 Glucose monitoring has transitioned from the SMBG to CGM owing to the demand for a less invasive method of measurement. CGM systems enable patients to monitor their BGL throughout the day, according to measurements taken at definite intervals of time as opposed to irregular, manually-set ones.…”

Section: Cgmmentioning

confidence: 99%

Artificial Pancreas System for Type 1 Diabetes—Challenges and Advancements

Kapil¹,

Saini²,

Wangnoo³

et al. 2020

Exploratory Research and Hypothesis in Medicine

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Type 1 diabetes mellitus is a chronic autoimmune disease, requiring glucose monitoring and intensive insulin therapy. Its therapeutic management aims to restore normal HbA1C and stabilize prandial and postprandial glucose levels. The burden of self-management of diabetes is high, and the growing requirement for blood glucose measuring devices presents a challenge. Such devices can continuously monitor glucose concentrations and automatically adjust insulin delivery rates, which in turn help to maintain blood glucose within a healthy range. The artificial pancreas system (so-called APS) technology has evolved rapidly over the past few years, capable of providing effective management of diabetes to improve quality of life of the type 1 diabetes mellitus patients. This review discusses the evolution of the APS technology and its progress in the various components: continuous subcutaneous insulin infusion, mathematical model, real-time continuous glucose monitoring, and control algorithms driving closed-loop control systems. The limitations and the proposed future directives are also discussed.

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“…The first CGM became commercially available in 1999. 8 CGM technology has greatly improved since then and several revolutionary developments in CGM technology have taken place over the past five years. These advances have all significantly reduced patients’ burden of diabetes care.…”

Section: Introductionmentioning

confidence: 99%

Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline

Galindo

Umpiérrez

Rushakoff

et al. 2020

J Diabetes Sci Technol

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This article is the work product of the Continuous Glucose Monitor and Automated Insulin Dosing Systems in the Hospital Consensus Guideline Panel, which was organized by Diabetes Technology Society and met virtually on April 23, 2020. The guideline panel consisted of 24 international experts in the use of continuous glucose monitors (CGMs) and automated insulin dosing (AID) systems representing adult endocrinology, pediatric endocrinology, obstetrics and gynecology, advanced practice nursing, diabetes care and education, clinical chemistry, bioengineering, and product liability law. The panelists reviewed the medical literature pertaining to five topics: (1) continuation of home CGMs after hospitalization, (2) initiation of CGMs in the hospital, (3) continuation of AID systems in the hospital, (4) logistics and hands-on care of hospitalized patients using CGMs and AID systems, and (5) data management of CGMs and AID systems in the hospital. The panelists then developed three types of recommendations for each topic, including clinical practice (to use the technology optimally), research (to improve the safety and effectiveness of the technology), and hospital policies (to build an environment for facilitating use of these devices) for each of the five topics. The panelists voted on 78 proposed recommendations. Based on the panel vote, 77 recommendations were classified as either strong or mild. One recommendation failed to reach consensus. Additional research is needed on CGMs and AID systems in the hospital setting regarding device accuracy, practices for deployment, data management, and achievable outcomes. This guideline is intended to support these technologies for the management of hospitalized patients with diabetes.

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Continuous Glucose Monitoring Devices: Past, Present, and Future Focus on the History and Evolution of Technological Innovation

Cited by 79 publications

References 46 publications

Continuous Glucose Monitoring in the Hospital

Continuous Glucose Monitoring in the Hospital

Artificial Pancreas System for Type 1 Diabetes—Challenges and Advancements

Continuous Glucose Monitors and Automated Insulin Dosing Systems in the Hospital Consensus Guideline

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