Continuous Glucose Monitoring System

지속형 혈당 모니터링 시스템

Yoo, Hye-Jin
류혜진

  • Published : 20100000

Abstract

Continuous glucose monitoring system (CGMS) represents the third era of diabetes management. This technology, which allows patients to view a direction and rate of blood glucose change every 5 minutes, permits fine tuning of a patient’s glycemic control that is not possible with self monitoring of blood glucose. The continuous availability of glucose measurements permitted the patients to adjust their own insulin doses, food intake and physical activity and thus improve their glycemic control. Furthermore, it helps to assess the glycemic excursion, which is known to be related with diabetic complications and to detect unrecognized hypoglycemia especially during sleep. However, because CGMS device is still early in its development, some practical aspects of its use must be considered before recommending CGMS to every patient with diabetes. In this report, we summarize the mechanism and limitation of the current CGMS device and the available data about the clinical utility of this novel glucose monitoring system.

Keywords

References

  1. Wadwa RP, Fiallo-Scharer R, Vanderwel B, Messer LH, Cobry E, Chase HP. Continuous glucose monitoring in youth with type 1 diabetes. Diabetes Technol Ther 2009;11 Suppl 1:S83-91
  2. Fabiato K, Buse J, Duclos M, Largay J, Izlar C, O'Connell T, Stallings J, Dungan K. Clinical experience with continuous glucose monitoring in adults. Diabetes Technol Ther 2009;11 Suppl 1:S93-103 https://doi.org/10.1089/dia.2008.0032
  3. Ceriello A. Postprandial hyperglycemia and diabetes complications: is it time to treat? Diabetes 2005;54:1-7 https://doi.org/10.2337/diabetes.54.1.1
  4. Adverse events and their association with treatment regimens in the diabetes control and complications trial. Diabetes Care 1995;18:1415-27 https://doi.org/10.2337/diacare.18.11.1415
  5. Tubiana-Rufi N, Riveline JP, Dardari D. Real-time continuous glucose monitoring using GuardianRT: from research to clinical practice. Diabetes Metab 2007;33:415-20 https://doi.org/10.1016/j.diabet.2007.05.003
  6. Garg S, Zisser H, Schwartz S, Bailey T, Kaplan R, Ellis S, Jovanovic L. Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose sensor: a randomized controlled trial. Diabetes Care 2006;29:44-50 https://doi.org/10.2337/diacare.29.01.06.dc05-1686
  7. Tamborlane WV, Beck RW, Bode BW, Buckingham B, Chase HP, Clemons R, Fiallo-Scharer R, Fox LA, Gilliam LK, Hirsch IB, Huang ES, Kollman C, Kowalski AJ, Laffel L, Lawrence JM, Lee J, Mauras N, O'Grady M, Ruedy KJ, Tansey M, Tsalikian E, Weinzimer S, Wilson DM, Wolpert H, Wysocki T, Xing D. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med 2008;359:1464-76 https://doi.org/10.1056/NEJMoa0805017
  8. American Diabetes Association. Standards of medical care in diabetes--2009. Diabetes Care 2009;32 Suppl 1:S13-61
  9. Yoo HJ, An HG, Park SY, Ryu OH, Kim HY, Seo JA, Hong EG, Shin DH, Kim YH, Kim SG, Choi KM, Park IB, Yu JM, Baik SH. Use of a real time continuous glucose monitoring system as a motivational device for poorly controlled type 2 diabetes. Diabetes Res Clin Pract 2008;82:73-9 https://doi.org/10.1016/j.diabres.2008.06.015
  10. Chitayat L, Zisser H, Jovanovic L. Continuous glucose monitoring during pregnancy. Diabetes Technol Ther 2009;11 Suppl 1:S105-11
  11. Kestila KK, Ekblad UU, Ronnemaa T. Continuous glucose monitoring versus self-monitoring of blood glucose in the treatment of gestational diabetes mellitus. Diabetes Res Clin Pract 2007;77:174-9 https://doi.org/10.1016/j.diabres.2006.12.012
  12. Goldberg PA, Siegel MD, Russell RR, Sherwin RS, Halickman JI, Cooper DA, Dziura JD, Inzucchi SE. Experience with the continuous glucose monitoring system in a medical intensive care unit. Diabetes Technol Ther 2004;6:339-47 https://doi.org/10.1089/152091504774198034
  13. Kowalski AJ. Can we really close the loop and how soon? Accelerating the availability of an artificial pancreas: a roadmap to better diabetes outcomes. Diabetes Technol Ther 2009;11 Suppl 1:S113-9 https://doi.org/10.1089/dia.2008.0021
  14. Buckingham B, Cobry E, Clinton P, Gage V, Caswell K, Kunselman E, Cameron F, Chase HP. Preventing hypoglycemia using predictive alarm algorithms and insulin pump suspension. Diabetes Technol Ther 2009;11:93-7 https://doi.org/10.1089/dia.2008.0032
  15. Gilliam LK, Hirsch IB. Practical aspects of real-time continuous glucose monitoring. Diabetes Technol Ther 2009;11 Suppl 1:S75-82