Real-time continuous glucose monitoring improves glycaemic variability and neonatal outcomes in pregnant women with type 1 diabetes

Abell, Sally K.; Zoungas, Sophia

doi:10.1136/bmjebm-2018-110927

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…Day-to-day exposure to maternal hyperglycemia and reduced glucose variability measured directly with CGM might be more relevant for neonatal outcomes than surrogate markers such as HbA1c (14).…”

Section: Commentmentioning

confidence: 99%

“…Diabetes Service, Division of Urgent Care, Planned Care and Allied Critical Services, King's College Hospital NHS Foundation Trust, London, UK;9 Sunnybrook Research Institute, Toronto, Canada;10 Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikvah, Israel;11 Division of Endocrinology, University of Southern California, Los Angeles;12 Department of Chemistry, University of California, Santa Barbara;13 Department of Medicine, University of Ottawa, and The Ottawa Hospital, Ottawa, Canada;14 Department of Medicine, St Joseph Health Care London, Canada;15 Department of Medicine, University of Western ON,…”

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confidence: 99%

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Continuous Glucose Monitoring in 2018

Bode

Battelino

2019

Diabetes Technology & Therapeutics

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A dvanced treatment modalities are generally associated with considerable additional costs for the payer. As the costs of medical care for diabetes represent an increasing share in most health-care budgets (1), payers design various strategies to limit the access to expensive treatment modalities. It is exceedingly rare that a novel, efficient, and safe treatment modality can incur cost reduction. Continuous glucose monitoring (CGM) seems to position itself into this uncommon category (2). Now unequivocally accepted as safe and efficient, and recommended in all clinical guidelines from all professional associations (3), CGM enters various public and private insurance systems with the proven potential to reduce acute morbidity and absenteeism, adding considerably to the total reduction of costs related to diabetes. The current article discusses recent clinical evidence associating CGM with reduction in morbidity related to glucose variability and hyper-and hypoglycemia, with the focus on well-being of people with diabetes (PWD) and, during pregnancy complicated by diabetes, also on their offspring. Indeed, CGM is ''transforming diabetes management step by step'' (4), among PWD as well as diabetes care providers. The CGM metric of time in target range (TIR) becomes more widely adopted, and its use combined with time in hypoglycemia can provide a more personalized approach to diabetes management. As always, PWD will have to decide whether CGM is their ''best friend or spy'' (5). CGM influences physical, emotional, and relational aspects of everyday life. Diabetes care providers can help reduce the burden of CGM with sensible delivered training and realistic expectations for PWD. Complementing the quality of life (QOL) outcomes in adults with diabetes, CGM use has been associated with less adolescent and parental distress compared to no technology use, along with lower glycosylated hemoglobin (HbA1c) (6). Empowerment and relational partnerships in diabetes care can optimize contentment and success with CGM. PWD seem to be perfectly ready-let's make sure that we, diabetes care providers, don't lag behind.

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Section: Commentmentioning

confidence: 99%