Therapeutic Use and Diagnostic Potential of Continuous Glucose Monitoring Systems (CGMS) in Adolescents

Glucose meters provide quantitative information about blood glucose concentration that is discontinuous. Continuous glucose monitoring systems (CGMS) using sensors provide time sequences data, including "quantity," and adding direction, rate of change and rate of acceleration. Therefore CGMS appear more informative, efficacious and safe as meters when used for treatment choices. Recently some important improvements are achieved in consistency, ease of use and incorporation with other technologies. From the therapeutic point, ambulatory sensors are currently approved and used with success to treat diabetic patients on insulin therapy. CGMS can provide the data needed to prevent hypoglycemia. In addition, CGMS technology is expanding its benefits for diagnostic use and behavior modification in prediabetes especially in high risk adolescents like those with obesity with or without family history of diabetes, metabolic syndrome, cystic fibrosis and thalassemia. This mini-review clarifies both the therapeutic and diagnostic capabilities and potential use of CGMS to diagnose and manage glycemic abnormalities in adolescents. Moreover it summarizes the results of studies that compare CGMS to other diagnostic tools, namely intermittent capillary glucose monitoring using glucometers, fasting venous glucose measurement, oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin (HbA1C) in the management of these adolescents. The possible early diagnosis of glycemic abnormalities using CGMS in adolescents and their timely management to prevent progression to diabetes appears to be an attractive future therapeutic approach.