Realistic Expectations and Practical Use of Continuous Glucose Monitoring for the Endocrinologist
Abstract
Context Real-time continuous glucose monitoring (CGM) has been available for type 1 diabetes for several years. This paper is a status report on our early experiences with this next technology. Evidence acquisition The two major sources of data acquisition included PubMed search strategies and personal experience of the author from clinical experience. Evidence synthesis Data assessing CGM accuracy, short-term outcomes (12 wk), and longer term outcomes (6 months) are reported. Potential strategies for successful and efficient use in an office or clinic setting are also discussed. Practical aspects of CGM use (alarm settings, using glycemic trending information) are also reviewed. Conclusions Accuracy of this technology has improved in the short amount of time it has been available. Six-month data suggest that patient selection is a key for success. Patients who do not understand or practice the basics of intensive insulin therapy have the greatest challenges. Those who do best watch the receiver frequently, continue with frequent home blood glucose monitoring, use the trending information to make insulin adjustments, and understand the limitations of the technology. With insurance reimbursement improving, CGM is gaining acceptance as an important tool for the management of type 1 diabetes. Like home blood glucose monitoring and insulin pump therapy, this technology by itself is not a panacea for diabetes control. However, it further adds to our ability to improve the lives of…
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Diabetes management in modern countries often includes use of insulin analogues and mechanical technologies (eg, insulin pumps and continuous glucose monitors) for improved treatment of type 1 disease.
“As a result, diabetes management in modern countries often includes use of insulin analogues and mechanical technologies (eg, insulin pumps and continuous glucose monitors) for improved treatment of type 1 disease.85”
From Type 1 diabetes (2014) · cites this paper as [85]
Cites
Continuous glucose monitoring and intensive treatment of type 1 diabetes
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Self-citationClosed-loop insulin delivery from bench to clinical practice
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“One way is to use the rate of glucose change to alter the premeal bolus, with a 1–2 mg/dL/min change indicating the need for a 10% adjustment in bolus dosing (a single arrow up or down), while adjusting the bolus dose by 20% when the CGM system alerts that glucose levels are more rapidly changing (more than 2 mg/dL/mi…”
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Giza, S., Kotanidou, E. P., Tsinopoulou, V. R., Poukoulidou, T., Ntouma, S., & Galli-Tsinopoulou, A. (2025) · Children · doi:10.3390/children12121668 · Cited by 7 · see citing works
- Authors
- Hirsch, I. B.
- Affiliations
- University of Washington (US)
- Corresponding author
- Hirsch, Irl B.
- ORCID
- Hirsch, Irl B.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-07-01
- Volume
- 94
- Issue
- 7
- Pages
- 2232-2238
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2158024433
- Cited by
- 93
- References
- 2
- Citations by year
- 2025: 4 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 5 · 2018: 10 · 2017: 2 · 2016: 9 · 2015: 8 · 2014: 4 · 2013: 5 · 2012: 3
- FWCI
- 5.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Washington
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- continuous glucose monitoring, type 1 diabetes, CGM accuracy, intensive insulin therapy, alarm settings, home blood glucose monitoring, patient selection, artificial pancreas, insurance reimbursement, diabetes management
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Endocrinology, Humans, Insulin Infusion Systems, Patient Education as Topic, Physician's Role, Blood Glucose Self-Monitoring, Patient Selection
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