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Prescribing of CGM in clinical practice and payer coverage criteria have expanded considering the wealth of evidence and expert recommendations supporting more widespread use. As the body of evidence continues to grow, a new supplement in Diabetes Technology & Therapeutics offers insights from leading clinicians on the latest findings and practical application of CGM. The supplement highlights real-world evidence and the unique role of CGM in the management of hypoglycemia and enhancing behavior modification among users of the technology. Special consideration is given to the economic impact of CGM and access issues that may be of particular interest to payer and managed care decision makers.
The articles included:
Past, Present, and Future of Continuous Glucose Monitors Satish K. Garg
Continuous Glucose Monitoring Impact and Implications of Real-World Evidence: Past, Present and Future James R. Gavin III and Clifford J. Bailey
What Role Might There Be for Continuous Glucose Monitoring in the Assessment of Diabetes Risk? Eden Miller, William H. Polonsky and Kevin Miller
Practical Application of Continuous Glucose Monitoring in Clinical Practice: Case Studies Jeff Unger and Denise R. Franco
Advancements in Diabetes Technology Are Outpacing the Evidence Michael Rickson, Eugene E. Wright Jr., Anila Bindal and Laith Ghonim
One Size Fits All Versus Individualized Medicine in Type 1 Diabetes Management L. Kurt Midyett
Is Continuous Glucose Monitoring a Tool, an Intervention, or Both? Eugene E. Wright Jr. and Savitha Subramanian
Continuous Glucose Monitoring Use in Older Adults for Optimal Diabetes Management Medha N. Munshi
Personalized Glycated Hemoglobin in Diabetes Management: Closing the Gap with Glucose Management Indicator Timothy C. Dunn, Yongjin Xu, Richard M. Bergenstal, Watru Ogawa and Ramzi A. Ajjan
Prevalence, Cost, and Burden of Diabetic Ketoacidosis Naunihal Virdi, Yeesha Poon, Richard Abaniel and Richard M. Bergenstal
The Wireless Innovation for Seniors with Diabetes Mellitus (WISDM) randomized clinical trial (RCT) featured a 26-week phase comparing real-time continuous glucose monitoring (RT-CGM) with blood glucose monitoring (BGM) in 203 adults aged ≥60 years with type 1 diabetes (T1D). Of the 198 participants who completed the RCT, 98% of RT-CGM group participants continued (CGM-CGM cohort) and 98% of BGM group participants crossed over to CGM (BGM-CGM cohort) for an additional 26 weeks. In the BGM-CGM cohort, median time <70 mg/dL decreased from 3.9% to 1.9% (P<0.001), TIR increased from 56% to 60% (P=0.006) and HbA1c decreased from 7.5% to 7.3% (P=0.025). Severe hypoglycemic events were reported for 9 participants while using BGM during the RCT and for only 2 participants during the extension phase with RT-CGM (P=0.02), indicating a sustained benefit of hypoglycemia avoidance in older adults out to 12 months.
Miller KM, et al. Benefit of Continuous Glucose Monitoring in Reducing Hypoglycemia Is Sustained Through 12 Months of Use Among Older Adults with Type 1 Diabetes. Diabetes Technol Ther. 2022;24(6):424-434.
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Source: The Journal of the American Medical Association
Authors: Monica E. Peek, MD, MPH, MS; Celeste C. Thomas, MD, MS
“…the studies by Karter et al. and Martens et al. provide additional evidence that patients with type 2 diabetes benefit from the use of CGM in terms of improved HbA1c level, time spent in the target blood glucose range, and reduced hypoglycemic episodes…”
“…institutional changes that promote its use in primary care will go a long way to improving diabetes control and reducing complications, particularly among the populations most in need. The time has come to broaden access to CGM for patients with type 2 diabetes.”
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