The impact of new glucose monitoring systems on parameters of diabetes metabolic control. Literature review
DOI:
https://doi.org/10.12775/JEHS.2024.67.50885Keywords
Continuous glucose monitor, cgm, flash glucose monitoring, fgm, type 1diabetes, type 2 diabetes, Metrics of Glycemic ManagmentAbstract
Introduction
In recent years, there has been tremendous development in medicine, including diabetology. A significant portion of these achievements pertains to pharmacological treatment. However, one should not overlook the advancement of devices necessary for monitoring glucose levels, such as glucometers or CGM and FGM systems. In this paper, I want to focus on how the use of glucose monitoring systems affects the course of diabetes.
Aim of the study
The aim of this study was to determine the impact of glucose monitoring systems (CGM and FGM) on parameters of metabolic control in diabetes.
Materials and methods
The article was created based on the PubMed and Scholar databases. The literature was analyzed using the following keywords: Continuous glucose monitor, CGM, flash glucose monitoring, FGM, type 1 diabetes, type 2 diabetes, diabetes mellitus, Metrics of Glycemic.
Results
Research has confirmed that the use of continuous glucose monitoring systems lowers HbA1c in patients with both type 1 and type 2 diabetes regardless of age and treatment modality. Furthermore, the use of CGM and FGM reduces the number of hypoglycemic episodes and increases time in range (TIR).
Conclusions
Thanks to the results obtained from numerous studies, it can be assumed that the use of continuous glucose monitoring systems is not only an adjunct to diabetes therapy but also an important component of it. With this technology combined with modern medications, we can achieve better glycemic control and, consequently, improve the quality of life of patients with diabetes.
References
Tinajero MG, Malik VS. An Update on the Epidemiology of Type 2 Diabetes: A Global Perspective. Endocrinol Metab Clin North Am. 2021 Sep;50(3):337-355. doi: 10.1016/j.ecl.2021.05.013.
Kołpa M, Grochowska A, Kubik B, Stradomska K. Lifestyle, metabolic compensation in patients with type 2 diabetes mellitus and the risk of chronic disease complications. Clin Diabetol 2018; 7, 3: 151–158. DOI: 10.5603/DK.2018.0011.
Cole JB, Florez JC. Genetics of diabetes mellitus and diabetes complications. Nat Rev Nephrol. 2020 Jul;16(7):377-390. doi: 10.1038/s41581-020-0278-5. Epub 2020 May 12.
Chua, S.-S., Ong, W. M., & Ng, C. J. (2014). Barriers and facilitators to self-monitoring of blood glucose in people with type 2 diabetes using insulin: a qualitative study. Patient Preference and Adherence, 237. doi:10.2147/ppa.s57567
Hortensius, J., Kars, M.C., Wierenga, W.S. et al. Perspectives of patients with type 1 or insulin-treated type 2 diabetes on self-monitoring of blood glucose: a qualitative study. BMC Public Health 12, 167 (2012). https://doi.org/10.1186/1471-2458-12-167
Ginsberg BH. Factors affecting blood glucose monitoring: sources of errors in measurement. J Diabetes Sci Technol. 2009 Jul 1;3(4):903-13. doi: 10.1177/193229680900300438.
Edelman, S. V., Argento, N. B., Pettus, J., & Hirsch, I. B. (2018). Clinical Implications of Real-time and Intermittently Scanned Continuous Glucose Monitoring. Diabetes Care, 41(11), 2265–2274. doi:10.2337/dc18-1150
Bergenstal RM, Gal RL, Connor CG, Gubitosi-Klug R, Kruger D, Olson BA, Willi SM, Aleppo G, Weinstock RS, Wood J, Rickels M, DiMeglio LA, Bethin KE, Marcovina S, Tassopoulos A, Lee S, Massaro E, Bzdick S, Ichihara B, Markmann E, McGuigan P, Woerner S, Ecker M, Beck RW; T1D Exchange Racial Differences Study Group. Racial Differences in the Relationship of Glucose Concentrations and Hemoglobin A1c Levels. Ann Intern Med. 2017 Jul 18;167(2):95-102. doi: 10.7326/M16-2596. Epub 2017 Jun 13.
Slattery D, Choudhary P. Clinical Use of Continuous Glucose Monitoring in Adults with Type 1 Diabetes. Diabetes Technol Ther. 2017 May;19(S2):S55-S61. doi: 10.1089/dia.2017.0051.
Maiorino, M. I., Signoriello, S., Maio, A., Chiodini, P., Bellastella, G., Scappaticcio, L., … Esposito, K. (2020). Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled Trials. Diabetes Care, 43(5), 1146–1156. doi:10.2337/dc19-1459
Lin, R., Brown, F., James, S., Jones, J., & Ekinci, E. (2021). Continuous glucose monitoring: A review of the evidence in type 1 and 2 diabetes mellitus. Diabetic Medicine, 38(5). doi:10.1111/dme.14528
Pettus, J., & Edelman, S. V. (2016). Use of Glucose Rate of Change Arrows to Adjust Insulin Therapy Among Individuals with Type 1 Diabetes Who Use Continuous Glucose Monitoring. Diabetes Technology & Therapeutics, 18(S2), S2–34–S2–42. doi:10.1089/dia.2015.0369
Wood A, O'Neal D, Furler J, Ekinci EI. Continuous glucose monitoring: a review of the evidence, opportunities for future use and ongoing challenges. Intern Med J. 2018 May;48(5):499-508. doi: 10.1111/imj.13770.
Bolinder J, Antuna R, Geelhoed-Duijvestijn P, Kröger J, Weitgasser R. Novel glucose-sensing technology and hypoglycaemia in type 1 diabetes: a multicentre, non-masked, randomised controlled trial. Lancet. 2016;388(10057):2254-2263. doi:10.1016/ S0140-6736(16)31535-5.
Yapanis M, James S, Craig ME, O'Neal D, Ekinci EI. Complications of Diabetes and Metrics of Glycemic Management Derived From Continuous Glucose Monitoring. J Clin Endocrinol Metab. 2022 May 17;107(6):e2221-e2236. doi: 10.1210/clinem/dgac034.
Wada, E., Onoue, T., Kobayashi, T., Handa, T., Hayase, A., Ito, M., … Arima, H. (2020). 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. BMJ Open Diabetes Research & Care, 8(1), e001115. doi:10.1136/bmjdrc-2019-001115
Martens T, Beck RW, Bailey R, Ruedy KJ, Calhoun P, Peters AL, Pop-Busui R, Philis-Tsimikas A, Bao S, Umpierrez G, Davis G, Kruger D, Bhargava A, Young L, McGill JB, Aleppo G, Nguyen QT, Orozco I, Biggs W, Lucas KJ, Polonsky WH, Buse JB, Price D, Bergenstal RM; MOBILE Study Group. Effect of Continuous Glucose Monitoring on Glycemic Control in Patients With Type 2 Diabetes Treated With Basal Insulin: A Randomized Clinical Trial. JAMA. 2021 Jun 8;325(22):2262-2272. doi: 10.1001/jama.2021.7444.
Beck RW, Riddlesworth T, Ruedy K, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial. JAMA. 2017;317(4):371–378. doi:10.1001/jama.2016.19975
Lee K, Gunasinghe S, Chapman A, et al. Real-World Outcomes of Glucose Sensor Use in Type 1 Diabetes-Findings from a Large UK Centre. Biosensors (Basel). 2021;11(11):457. Published 2021 Nov 15. doi:10.3390/bios11110457
Laffel LM, Kanapka LG, Beck RW, et al. Effect of Continuous Glucose Monitoring on Glycemic Control in Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial. JAMA. 2020;323(23):2388–2396. doi:10.1001/jama.2020.6940
Pratley RE, Kanapka LG, Rickels MR, et al. Effect of Continuous Glucose Monitoring on Hypoglycemia in Older Adults With Type 1 Diabetes: A Randomized Clinical Trial. JAMA. 2020;323(23):2397–2406. doi:10.1001/jama.2020.6928
Hansen KW. Effects of unrestricted access to flash glucose monitoring in type 1 diabetes. Endocrinol Diabetes Metab. 2020 Mar 19;3(3):e00125. doi: 10.1002/edm2.125.
Oskarsson P, Antuna R, Geelhoed-Duijvestijn P, Krӧger J, Weitgasser R, Bolinder J. Impact of flash glucose monitoring on hypoglycaemia in adults with type 1 diabetes managed with multiple daily injection therapy: a pre-specified subgroup analysis of the IMPACT randomised controlled trial. Diabetologia. 2018 Mar;61(3):539-550. doi: 10.1007/s00125-017-4527-5.
Heinemann L, Freckmann G, Ehrmann D, Faber-Heinemann G, Guerra S, Waldenmaier D, Hermanns N. Real-time continuous glucose monitoring in adults with type 1 diabetes and impaired hypoglycaemia awareness or severe hypoglycaemia treated with multiple daily insulin injections (HypoDE): a multicentre, randomised controlled trial. Lancet. 2018 Apr 7;391(10128):1367-1377. doi: 10.1016/S0140-6736(18)30297-6. Epub 2018 Feb 16.
van Beers CA, DeVries JH, Kleijer SJ, Smits MM, Geelhoed-Duijvestijn PH, Kramer MH, Diamant M, Snoek FJ, Serné EH. Continuous glucose monitoring for patients with type 1 diabetes and impaired awareness of hypoglycaemia (IN CONTROL): a randomised, open-label, crossover trial. Lancet Diabetes Endocrinol. 2016 Nov;4(11):893-902. doi: 10.1016/S2213-8587(16)30193-0. Epub 2016 Sep 15.
Karter AJ, Parker MM, Moffet HH, Gilliam LK, Dlott R. Continuous Glucose Monitor Use Prevents Glycemic Deterioration in Insulin-Treated Patients with Type 2 Diabetes. Diabetes Technol Ther. 2022 May;24(5):332-337. doi: 10.1089/dia.2021.0450. Epub 2022 Feb 18.
Lind M, Polonsky W, Hirsch IB, Heise T, Bolinder J, Dahlqvist S, Schwarz E, Ólafsdóttir AF, Frid A, Wedel H, Ahlén E, Nyström T, Hellman J. Continuous Glucose Monitoring vs Conventional Therapy for Glycemic Control in Adults With Type 1 Diabetes Treated With Multiple Daily Insulin Injections: The GOLD Randomized Clinical Trial. JAMA. 2017 Jan 24;317(4):379-387. doi: 10.1001/jama.2016.19976. Erratum in: JAMA. 2017 May 9;317(18):1912.
Tyndall V, Stimson RH, Zammitt NN, Ritchie SA, McKnight JA, Dover AR, Gibb FW. Marked improvement in HbA1c following commencement of flash glucose monitoring in people with type 1 diabetes. Diabetologia. 2019 Aug;62(8):1349-1356. doi: 10.1007/s00125-019-4894-1. Epub 2019 Jun 9.
Gilbert TR, Noar A, Blalock O, Polonsky WH. Change in Hemoglobin A1c and Quality of Life with Real-Time Continuous Glucose Monitoring Use by People with Insulin-Treated Diabetes in the Landmark Study. Diabetes Technol Ther. 2021 Mar;23(S1):S35-S39. doi: 10.1089/dia.2020.0666.
Teo E, Hassan N, Tam W, Koh S. Effectiveness of continuous glucose monitoring in maintaining glycaemic control among people with type 1 diabetes mellitus: a systematic review of randomised controlled trials and meta-analysis. Diabetologia. 2022 Apr;65(4):604-619. doi: 10.1007/s00125-021-05648-4. Epub 2022 Feb 9.
Yaron, M., Roitman, E., Aharon-Hananel, G., Landau, Z., Ganz, T., Yanuv, I., Raz, I. (2019). Effect of Flash Glucose Monitoring Technology on Glycemic Control and Treatment Satisfaction in Patients With Type 2 Diabetes. Diabetes Care, dc180166. doi:10.2337/dc18-0166
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Weronika Salasa, Tomasz Seredyński, Wojciech Mądry, Aleksandra Mazurkiewicz, Magdalena Kołodziej, Joanna Męczyńska, Nazarii Saiuk, Michał Andrzej Kozicz, Adriana Wojciechowska, Justyna Marcicka
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 443
Number of citations: 0
