Continuous glucose monitoring system and new era of early diagnosis of diabetes in high risk groups

Ashraf Soliman, Vincenzo DeSanctis, Mohamed Yassin, Rania Elalaily, Nagwa E Eldarsy, Ashraf Soliman, Vincenzo DeSanctis, Mohamed Yassin, Rania Elalaily, Nagwa E Eldarsy

Abstract

Continuous glucose monitoring (CGM) systems are an emerging technology that allows frequent glucose measurements to monitor glucose trends in real time. Their use as a diagnostic tool is still developing and appears to be promising. Combining intermittent glucose self-monitoring (SGM) and CGM combines the benefits of both. Significant improvement in the treatment modalities that may prevent the progress of prediabetes to diabetes have been achieved recently and dictates screening of high risk patients for early diagnosis and management of glycemic abnormalities. The use of CGMS in the diagnosis of early dysglycemia (prediabetes) especially in high risk patients appears to be an attractive approach. In this review we searched the literature to investigate the value of using CGMS as a diagnostic tool compared to other known tools, namely oral glucose tolerance test (OGTT) and measurement of glycated hemoglobin (HbA1C) in high risk groups. Those categories of patients include adolescents and adults with obesity especially those with family history of type 2 diabetes mellitus, polycystic ovary syndrome (PCO), gestational diabetes, cystic fibrosis, thalassemia major, acute coronary syndrome (ACS), and after renal transplantation. It appears that the ability of the CGMS for frequently monitoring (every 5 min) glucose changes during real-life settings for 3 to 5 days stretches the chance to detect more glycemic abnormalities during basal and postprandial conditions compared to other short-timed methods.

Keywords: Continuous glucose monitoring system; Glycated hemoglobin (HbA1C); obesity; oral glucose tolerance test; thalassemia.

Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
A CGM tracing one thalassemic patient with normal glucose tolerance (0 h = 98 mg/dl, 2h = 124 mg/dl) and twice abnormal (diabetic) postprandial blood glucose (red rectangles)

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