Continuous Glucose Monitoring: A Consensus Conference of the American Association of Clinical Endocrinologists and American College of Endocrinology |
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| Institution: | 1. From the Professor of Medicine and Pharmacology, Tullis Tulane Alumni Chair in Diabetes, Chief, Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, Louisiana;2. President, American Association of Clinical Endocrinologists, Chairman, Grunberger Diabetes Institute, Bloomfield Hills, Michigan, Clinical Professor, Internal Medicine and Molecular Medicine & Genetics, Wayne State University School of Medicine, Detroit, Michigan, Professor, Internal Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan, Visiting Professor, Internal Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic;3. Chief Medical Officer, T1D Exchange, Boston, Massachusetts;4. Director, AMCR Institute, Clinical Associate Professor, UCSD School of Medicine, San Diego, California;5. Texas Diabetes and Endocrinology, Austin, Texas;6. Professor of Medicine and Pediatrics, Director, Adult Program, Editor-in-Chief, Diabetes Technology and Therapeutics, Barbara Davis Center for Diabetes, University of Colorado Denver, Aurora, Colorado;7. Medical Director & Principal Investigator, Metabolic Institute of America, Immediate Past President, American College of Endocrinology, Tarzana, California;8. Professor of Medicine, University of Washington School of Medicine, Seattle, Washington;9. Endocrinology Associates, Houston, Texas;10. Professor of Internal Medicine, University of Central Florida College of Medicine, Orlando, Florida;11. Professor and Chief of Pediatric Endocrinology, Yale School of Medicine, New Haven, Connecticut.;1. Skaggs School of Pharmacy and Pharmaceutical Sciences;2. Barbara Davis Center for Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado;;3. Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.;1. From the Director, AMCR Institute Escondido, California Clinical Associate Professor, University of California, San Diego School of Medicine;2. Chairman, Grunberger Diabetes Institute; Clinical Professor, Internal Medicine and Molecular Medicine & Genetics, Wayne State University School of Medicine; Professor, Internal Medicine Oakland University William Beaumont School of Medicine Bloomfield Hills, Michigan;3. Atlanta Diabetes Associates; Associate Professor of Medicine, Emory University School of Medicine Atlanta, Georgia;4. Medical Director and Principal Investigator, Metabolic Institute of America; President, American College of Endocrinology Tarzana, California;5. Professor of Medicine, University of Washington School of Medicine Seattle, Washington;6. Physician Consultant, Sansum Diabetes Research Institute; Clinical Professor of Medicine, University of Southern California-Keck School of Medicine; Attending Physician-Santa Barbara County Health Care Services; Adjunct Professor, Biomolecular Science and Engineering and Chemical Engineering, University of California-Santa Barbara Santa Barbara, California;7. Professor of Internal Medicine, University of Central Florida College of Medicine Orlando, Florida;8. Chief Scientific Officer, Biomedical Informatics Consultants LLC Potomac, Maryland;9. Professor and Chief of Pediatric Endocrinology, Yale School of Medicine New Haven, Connecticut;10. Diabetes Clinical Specialist, AMCR Institute Escondido, California |
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| Abstract: | 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 hemoglobinAACE = American Association of Clinical EndocrinologistsACE = American College of EndocrinologyASPIRE = Automation to Simulate Pancreatic Insulin ResponseCGM = continuous glucose monitoringHRQOL = health-related quality of lifeICER = incremental cost-effectiveness ratioJDRF = Juvenile Diabetes Research FoundationMARD = mean absolute relative differenceMDI = multiple daily injectionsQALY = quality-adjusted life yearsRCT = randomized, controlled trialSAP = sensor-augmented pumpSMBG = self-monitoring of blood glucoseSTAR = Sensor-Augmented Pump Therapy for A1C ReductionT1D = type 1 diabetesT2D = type 2 diabetes |
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