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Continuous Glucose Monitoring

Continuous Glucose Monitoring. Thomas Repas D.O. Diabetes, Endocrinology and Nutrition Center, Affinity Medical Group, Neenah, Wisconsin Member, Inpatient Diabetes Management Committee, St. Elizabeth’s Hospital, Appleton, WI

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Continuous Glucose Monitoring

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  1. Continuous Glucose Monitoring Thomas Repas D.O. Diabetes, Endocrinology and Nutrition Center, Affinity Medical Group, Neenah, Wisconsin Member, Inpatient Diabetes Management Committee, St. Elizabeth’s Hospital, Appleton, WI Member, Diabetes Advisory Group, Wisconsin Diabetes Prevention and Control Program Website: www.endocrinology-online.com

  2. MiniMed Continuous Glucose Monitoring System (CGMS)

  3. Interstitial Fluid Measurement • Interstitial fluid glucose (G2) is almost always comparable with blood glucose (G1)

  4. 400 300 250 200 150 100 50 Meal Meal Meal Meal Meal Meal 0 Midnight Noon Midnight Noon Midnight Continuous Glucose Monitoring Type 1 Normal 2-day tracing

  5. CGMS Indications While the system may be used effectively with all diabetes patients, it may be of particular use in evaluating the following conditions and situations: • Elevated glycosylated hemoglobin (HbA1c) • Hypoglycemic episodes and unawareness • Hyperglycemic episodes • Diabetic ketoacidosis • Unexplained blood glucose excursions • Gastroparesis • Gestational diabetes, preconception, pregnancy and nursing • Evaluation of therapeutic changes to medication regimen • Evaluation of behavioral modifications affecting glycemic control • Patients undergoing erythropoietin therapy or with hemolytic disorders because HbA1c may be unreliable

  6. Snapshot vs. Continuous 4 times/day

  7. Snapshot vs. Continuous 288 times/day

  8. CGMS Pilot Study HbA1c (%) N=9 p=0.0006 p=0.021, from Baseline Bode, et al., Diabetes Research and Clinical Practice, 1999, 46:183-190.

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