CONTINUOUS GLUCOSE MONITORING: A CONSENSUS CONFERENCE OF THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY.
OBJECTIVE/METHODS Barriers to continuous glucose monitoring (CGM) use continue to hamper adoption of this valuable technology for the management of diabetes. The American Association of Clinical Endocrinologists and the American College of Endocrinology convened a public consensus conference February 20, 2016, to review available CGM data and propose strategies for expanding CGM access. RESULTS Conference participants agreed that evidence supports the benefits of CGM in type 1 diabetes and that these benefits are likely to apply whenever intensive insulin therapy is used, regardless of diabetes type. CGM is likely to reduce healthcare resource utilization for acute and chronic complications, although real world analyses are needed to confirm potential cost savings and quality of life improvements. Ongoing technological advances have improved CGM accuracy and usability, but more innovations in human factors, data delivery, reporting, and interpretation are needed to foster expanded use. The development of a standardized data report using similar metrics across all devices would facilitate clinician and patient understanding and utilization of CGM. Expanded CGM coverage by government and private payers is an urgent need. CONCLUSION CGM improves glycemic control, reduces hypoglycemia, and may reduce overall costs of diabetes management. Expanding CGM coverage and utilization is likely to improve the health outcomes of people with diabetes. ABBREVIATIONS A1C glycated hemoglobin AACE American Association of Clinical Endocrinologists ACE American College of Endocrinology ASPIRE Automation to Simulate Pancreatic Insulin Response CGM continuous glucose monitoring HRQOL health related quality of life ICER incremental cost effectiveness ratio JDRF Juvenile Diabetes Research Foundation MARD mean absolute relative difference MDI multiple daily injections QALY quality adjusted life years RCT randomized, controlled trial SAP sensor augmented pump SMBG self monitoring of blood glucose STAR Sensor Augmented Pump Therapy for A1C Reduction T1D type 1 diabetes T2D type 2 diabetes.
Endocrine practice official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists