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Open Access 07-09-2023 | Diabetes | Review

An updated algorithm for an effective choice of continuous glucose monitoring for people with insulin-treated diabetes

Authors: Maria Ida Maiorino, Raffaella Buzzetti, Concetta Irace, Luigi Laviola, Nicola Napoli, Dario Pitocco, Katherine Esposito, on behalf of LIVE CGM working group

Published in: Endocrine | Issue 2/2023

Abstract

Purpose

Continuous Glucose Monitoring (CGM) is a key tool for insulin-treated people with diabetes (PwD). CGM devices include both real-time CGM (rtCGM) and intermittently scanned CGM (isCGM), which are associated with an improvement of glucose control and less hypoglycemia in clinical trials of people with type 1 and type 2 diabetes.

Methods

This is an expert position to update a previous algorithm on the most suitable choice of CGM for insulin-treated PwD in light of the recent evidence and clinical practice.

Results

We identified six different clinical scenarios, including type 1 diabetes, type 2 diabetes, pregnancy on intensive insulin therapy, regular physical exercise, new onset of diabetes, and frailty. The use of rtCGM or isCGM is suggested, on the basis of the predominant clinical issue, as suboptimal glucose control or disabling hypoglycemia, regardless of baseline HbA_1c or individualized HbA_1c target.

Conclusion

The present algorithm may help to select the best CGM device based on patients’ clinical characteristics, needs and clinical context, offering a further opportunity of a “tailored” therapy for people with insulin-treated diabetes.

Available only for authorised users

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Title: An updated algorithm for an effective choice of continuous glucose monitoring for people with insulin-treated diabetes
Authors: Maria Ida Maiorino
Raffaella Buzzetti
Concetta Irace
Luigi Laviola
Nicola Napoli
Dario Pitocco
Katherine Esposito
on behalf of LIVE CGM working group
Publication date: 07-09-2023
Publisher: Springer US
Keywords: Diabetes
Hypoglycemia
Insulins
Type 1 Diabetes
Type 2 Diabetes
Endocrinology
Insulins
Published in: Endocrine / Issue 2/2023
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-023-03473-w

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