Individualizing Care for the Many The Evolving Role of Professional Continuous Glucose Monitoring Systems in Clinical Practice

PurposeA generation of individuals with diabetes has come of age since the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study, providing demonstrable evidence that optimal glycemic control, achieved early with intensive therapy, yields a durable beneficial effect. Yet realizing the full potential of intensive therapy requires more frequent glucose monitoring and accurate interpretation of data. Because patients typically check no more than 3 or 4 times per day and rarely during the night, glucose variability, including glycemic spikes and asymptomatic hypoglycemia, may be missed. Short-term use of a professional continuous glucose monitoring (CGM) device, worn by patients without access to real-time data, reveals patterns of high and low blood glucose undetectable by self-monitoring of blood glucose (SMBG) alone. Clinicians interpret the continuous profile retrospectively to identify and adjust components of the insulin regimen responsible for nocturnal hypoglycemia...