Patient-centered diabetic care: the role of continuous glucose monitoring

Abstract

With more than 23.6 million Americans living with diabetes mellitus and a growing rate of 1.6 million new cases per year, improved control and the prevention of secondary complications is imperative. Reliance on hemoglobin A1c reading alone can be misleading to the physician and its value difficult for the patient to comprehend. Moreover, current research suggests that glycemic spikes, undetected by hemoglobin A1c, are a risk factor for the development of vascular and neurologic complications. Three-day continuous glucose monitoring offers a decided advantage in control of diabetes and also involves the patient in decision-making. Data collected by the monitor is downloaded into a computer and printed out, in color, as pie charts, daily line graphs, and composite summaries. Patient-recorded glucometer values are also displayed on the line graphs. The physician can review the summaries for episodes of hypoglycemia and glycemic spikes and make immediate correction to the care plan if necessary. When these summaries are presented to the patient, they can easily comprehend the effect their diet, activity, and medications have on their disease state. Furthermore, capillary sensor data is compared with patient-recorded glucometer values in an effort to evaluate technique and identify inaccurate glucometers. Enhanced understanding on the part of the patient and physician, as well as joint collaboration, has been proven to improve control of this disease.