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Insulin Delivery and Glucose Monitoring Methods for Diabetes Mellitus: Comparative Effectiveness

Slide: 6 of 25

Background: Managing Diabetes With Glucose Monitoring and Glycemic Control (1 of 2)

The recommended method for assessing long-term glycemic control over the previous 2 to 3 months in patients with type 1 or type 2 diabetes is to measure glycosylated hemoglobin, specifically hemoglobin A1c (HbA1c).

For assessing short-term glycemic control, particularly in patients using MDI or CSII, newer and more effective blood glucose-monitoring strategies are available, namely SMBG or rt-CGM.

Following publication of the results of the Diabetes Control and Complications Trial, SMBG by fingerstick replaced the assessment of glucose by urine dipstick and is now the most widely used technique.

rt-CGM systems were first approved by the U.S. Food and Drug Administration in 2005. This equipment consists of a transcutaneous glucose sensor that is connected to a transmitter and receiver. Some rt-CGM systems show graphical representation of glucose levels, and some have adjustable alarms for alerts of high and low glucose values. Sensor-augmented pumps that combine rt-CGM systems with CSII are also available.

Abbreviations: CSII = continuous subcutaneous insulin infusion; MDI = multiple daily injections; rt-CGM = real time-continuous glucose monitoring; SMBG = self-monitoring of blood glucose