Continuous glucose monitoring: evidence and consensus statement for clinical use.

Continuous glucose monitoring (CGM) is an essential tool for modern diabetes therapy. Randomized controlled studies have provided evidence that hemoglobin A1c (HbA1c) results can be improved in patients with type 1 diabetes with elevated baseline HbA1c when using CGM frequently enough and that the frequency and duration of hypoglycemic events can be reduced in patients with satisfactory baseline HbA1c. The CGM group within the Working Group Diabetes Technology (AGDT) of the German Diabetes Association (DDG) has defined evidence-based indications for the practical use of CGM in this consensus statement related to hypoglycemia (frequent, severe, or nocturnal) or hypoglycemia unawareness, insufficient metabolic control despite use of all possible therapeutic options and patient compliance, pregnancy associated with inadequate blood glucose results, and the need for more than 10 blood glucose measurements per day.

How would patients behave if they were continually informed of their blood glucose levels? A simulation study using a "virtual" patient.

Background: The emergence of real-time glucose sensors for people with diabetes may replace discontinuous monitoring (self-monitored blood glucose [BG]) in the future. In this study, we use a computer-generated "virtual" patient to predict changes in behavior that may result from an increased awareness of BG levels.

Methods: The employed strategy required educated patients with type 1 diabetes to simulate a virtual patient using the DIABLOG Scientific simulator, interactive computer program.

Are there time and cost savings by using telemanagement for patients on intensified insulin therapy? A randomised, controlled trial.

Background: Patients with insulin dependent diabetes require frequent advice if their metabolic control is not optimal. This study focuses on the fiscal and administrative aspects of telemanagement, which was used to establish a supervised autonomy of patients on intensified insulin therapy.

Methods: A prospective, randomised trial with 43 patients on intensified insulin therapy was conducted.