Continuous Glucose Monitors Offer Substantial Glucose Improvements in Patients with Poorly Controlled Diabetes
Traditional diabetes monitoring involves a fingerstick blood glucose reading. Non-adherence to the patient’s prescribed blood glucose monitor frequency is common.
Due to single-point-in-time measurements, BGM patients may miss sudden glucose changes. A1c measurements are the gold standard for figuring out the average glucose level over the course of 3 months, but they aren’t useful for daily readings or sudden changes in glucose.
Continuous glucose monitors (CGMs) benefit diabetic patients by continuously tracking glucose trends. CGMs eliminates the need for frequent fingerstick use and carrying BGM supplies.
In May 2022, the FDA cleared the next-generation FreeStyle Libre 3 system (Abbott) for use in patients 4 years of age or older living with diabetes. The device is about the size of 2 stacked US pennies and is worn on the back of the upper arm with a 1-piece applicator that allows for easy application.
The system is intended for use with the FreeStyle Libre 3 iOS and Android mobile apps, which allows users to view their glucose levels in real-time, track their glucose history and trends, and set up optional alarms with notifications to alert the user of serious medical events, such as hypoglycemia.
CGM data is easily accessible to patients and providers through these smartphone applications or handheld monitors. CGMs can send life-saving alerts to people who have had diabetes for a long time, take a lot of insulin, or are at risk for low blood sugar.
A retrospective study published in Clinical Diabetes evaluated pharmacists’ impact on glycemic outcomes using a flash CGM in 3 patients with poorly controlled diabetes. The percent time in range (TIR), time below range (TBR), time above range (TAR), and the glucose management indicator (GMI) (GMI) were all evaluated by the researchers.
CGM data inform clinicians and pharmacists of the frequency and degree of glucose fluctuations. Using up-to-date glucose readings, clinicians adjusted therapy promptly as needed based on patient-specific factors. Telehealth visits allow clinicians to monitor therapy responses remotely.
During 2 weeks to 3 months of CGM use, glucose variability was reduced by 3–4%. Two patients’ TIR rose 6% and 17%. One patient’s TIR remained the same after 3 months of down titration and stopping basal insulin.
Lifestyle changes and therapy reduced hypoglycemia and TIR. After using CGM, all patients improved glycemic control, AGP, and diet.
CGMs help patients understand glucose metrics and make therapy and lifestyle changes. Pharmacists tracked CGM data to improve patient outcomes, education, and burden.