ABSTRACT
Continuous glucose monitoring (CGM) use has expanded rapidly in recent years among people with both type 1 and type 2 diabetes. In concert with the globally increasing prevalence of type 2 diabetes, the majority of whom receive diabetes care from internists or family physicians rather than specialists, it is becoming increasingly incumbent upon physicians within internal medicine and family practice to interpret and utilize CGM data in real-world clinical practice. It is therefore of paramount importance that internists and family physicians have access to the tools which will enable them to (1) interpret CGM data, and (2) utilize CGM data to guide therapeutic modifications for their patients with type 2 diabetes. Given the limited amount of time available to internists and family physicians to address multiple complex topics in a typical office visit, a pragmatic, simple, and systematic approach to CGM interpretation is crucial. This article aims to provide internists and family physicians with a simplified and systematic approach to CGM interpretation that can be easily and efficiently implemented in a brief office visit.
Plain Language Summary
Continuous glucose monitoring (CGM) allows people with diabetes to automatically monitor glucose levels throughout the day and night, helps them to make informed decisions about food choices and physical activity, and assists people with diabetes and their healthcare providers in adjusting diabetes medications. CGM use has increased greatly in recent years among people with both type 1 and type 2 diabetes. As the number of people with type 2 diabetes increases around the world, internists and family physicians increasingly need to understand CGM data and guide their patients who use CGM. As a result, internists and family physicians need to have the tools which will enable them to (1) interpret CGM data, and (2) use CGM data to help their patients adjust their diabetes therapies. Since internists and family physicians have limited time to address many medical issues in a typical office visit, a simple and systematic approach to CGM interpretation is needed. This article aims to provide internists and family physicians with a simple and orderly approach to CGM interpretation that can be easily and efficiently used in a brief office visit.
Abbreviations
AGP | = | ambulatory glucose profile |
CAD | = | coronary artery disease |
CGM | = | continuous glucose monitoring |
CV | = | coefficient of variation |
GLP-1 RA | = | glucagon-like peptide 1 receptor agonist |
GV | = | glycemic variability |
HbA1c | = | hemoglobin A1c |
IQR | = | interquartile range |
isCGM | = | intermittently scanned CGM |
SGLT-2 | = | sodium-glucose co-transporter 2 |
TAR | = | time above range |
TBR | = | time below range |
TIR | = | time in range |
Acknowledgments
This article was supported by the Division of Endocrinology, Metabolism and Molecular Medicine at Northwestern University.
Disclosure of any financial/other conflicts of interest
E.D.S. has no competing financial interests. G.A. has served as consultant for Bayer, Dexcom, Inc., and Insulet Corporation and has received research support from Dexcom, Eli Lilly, Emmes, Fractyl Health and Insulet Corporation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
A reviewer on this manuscript has disclosed ‘I have been an advisor and consultant to Abbott Diabetes Care and advise, consult and speak on the use and interpretation of the AGP.’ Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.