Early Patient and Clinician Experiences with Continuous Glucose Monitoring

Fifteen years after publication of landmark studies that clearly demonstrated the benefits of intensive diabetes management, patients continue to fall short of glycemic goals. The risk of hypoglycemia remains a major barrier to optimal glycemic control. Continuous glucose monitoring (CGM) can assist in overcoming some of the limitations of self-monitoring of blood glucose by providing the ability to track glucose levels 24 hours a day, observe glucose trends and patterns, and receive alarms or alerts for actual and impending hypo- and hyperglycemia. In the brief time it has been available, studies have already demonstrated an association between the use of CGM and less time spent in hypo- and hyperglycemia, reduced glycemic variability, and reduced hemoglobin A1c levels. Because little information exists in the literature regarding teaching and learning experiences to assist clinicians beginning to incorporate CGM into their practices, the training and user experience from a 12-week study of patients using the FreeStyle Navigator CGM system was evaluated. Through responses to questionnaires, clinicians indicated the ability to train easily on the CGM system, and both patients and clinicians felt that they were able to make more informed decisions on therapy adjustments based on information from the receiver and the data management reports. It is important for clinicians and patients to understand the scope and limitations of this new technology to prevent unrealistic expectations. It is imperative to provide adequate training and education to effectively manage and use the large amount of data made available by CGM.