Continuous Home Monitoring of Glucose
Improved glycemic control with real-life use of continuous glucose sensors in adult subjects with type 1 diabetes
- Satish K. Garg, MD123,
- William C. Kelly, BS1,
- Mary K. Voelmle, MS, FNP, CDE13,
- Peter J. Ritchie, BA1,
- Peter A. Gottlieb, MD123,
- Kim K. McFann, PHD14 and
- Samuel L. Ellis, PHARMD, CDE1
- 1Barbara Davis Center for Childhood Diabetes, University of Colorado Health Sciences Center, Aurora, Colorado
- 2Department of Internal Medicine, University of Colorado at Denver, Aurora, Colorado
- 3Department of Pediatrics, University of Colorado at Denver, Aurora, Colorado
- 4Department of Preventive Medicine and Biometrics, University of Colorado at Denver, Aurora, Colorado
- Address correspondence and reprint requests to Satish K. Garg, MD, Barbara Davis Center for Childhood Diabetes, University of Colorado at Denver, 1775 North Ursula St., Aurora, CO 80045. E-mail: satish.garg{at}uchsc.edu
- ATR, above target range
- BTR, below target range
- CGM, continuous glucose monitoring
- CHMG, continuous home monitoring of glucose
- WTR, within target range
Improving metabolic control reduces micro- and macrovascular complications of diabetes. However, intensive insulin therapy increases severe hypoglycemia more than threefold (1–3). Continuous glucose monitoring (CGM) is being introduced into routine clinical care despite a lack of reimbursement. Registration studies for the Food and Drug Administration (FDA) documented that subjects using real-time CGM improve glucose excursions, reduce variability, decrease time spent in hypoglycemia and hyperglycemia, and improve A1C values (4–9). Despite these reports, there are data unsupportive of new technologies such as CGM (10) or personal digital assistants (11) for reducing hypoglycemia. This study evaluates glucose control and its relationship with glucose target ranges with continuous home monitoring of glucose (CHMG).
RESEARCH DESIGN AND METHODS
Inclusion criteria limited analysis to subjects with A1C values and downloaded CHMG data at baseline and 3 months, as well as software to download receivers (not available for the first 9 months). Patients who were pregnant or planning a pregnancy were excluded.
A total of 24 subjects on CHMG were included in this analysis. All patients in this study used the DexCom STS sensor (DexCoM, San Diego, CA). Subjects were computer matched for baseline A1C (± 0.3%), sex, age, and duration of diabetes except for one subject in the CHMG group, who had diabetes for 57 years. Baseline demographics were similar between groups (Table 1). This protocol was institutional review board approved.
Subjects initiating CHMG attended a session on glucose trends, features of the CHMG …
