Published recently in US Endocrinology, the peer-reviewed journal from touchENDOCRINOLOGY, Stephen M Twigg et al discuss established methods of self-monitoring of glucose levels include capillary self-monitoring of blood glucose (SMBG) and interstitial continuous glucose monitoring (CGM). Flash CGM is a novel form of self-monitoring that provides on-demand continuous interstitial glucose profiles. The purpose of this article is to critically review the recent outcome data from randomized controlled trials that assessed the efficacy and safety of flash CGM to replace routine SMBG in diabetes management. Methods: Two recent six-month, prospective, multicenter, randomized controlled trials in type 1 (IMPACT; NCT02232698) and type 2 (REPLACE; NCT02082184) diabetes compared flash CGM with SMBG under otherwise usual care conditions. The trials did not use a prescribed treatment algorithm based on self-monitoring of glucose. Results: Both trials demonstrated that the time spent in hypoglycemia over a 24-hour period, as well as overnight, was markedly reduced by flash CGM without deterioration in glycated hemoglobin (A1C) levels. In IMPACT there was a 38% reduction in time in hypoglycemia with flash CGM versus SMBG, and in REPLACE there was a 43% reduction in time in hypoglycemia with flash CGM compared with SMBG. Moreover, patient satisfaction improved with flash CGM, usage adherence rates were high, and flash CGM was well tolerated. Conclusions: The findings from these trials suggest that improved care outcomes can be achieved when flash CGM is integrated into current established clinical care paradigms. Flash CGM provides important advantages over SMBG that are likely to be applicable to real-world care of individuals with differing forms of diabetes requiring intensive insulin treatment.
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Disclosure: Stephen M Twigg is an advisory panel member and is on the speaker's bureau for Abbott Diabetes Care, Astra Zeneca, Novo Nordisk Australia, Sanofi- Aventis, Eli Lilly and Company and Boehringer Ingelheim Pharmaceuticals. He is on the speaker's bureau only for Takeda Pharmaceutical Company Limited, Merck Sharp & Dohme Corporation, Novartis Pharmaceuticals Corporation, and Servier. Mahmood R Kazemi is an employee of Abbott Diabetes Care. Maria E Craig is an advisory panel member for Abbott Diabetes Care, and is on the speaker's bureau for Novo Nordisk Australia, Pfizer Australia. Abbott Diabetes Care has contracted with Watermeadow Medical (UK) to manage and prepare this manuscript.
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