Adjustment of Insulin Therapy: New Insights from Continuous Glucose Monitoring / 임상당뇨병

ABSTRACT

Diabetes management technology has advanced dramatically in recent decades, particularly real time continuous glucose monitoring (rtCGM) systems. A recent meta-analysis showed that rtCGM can reduce HbA1c by around 0.3% compared to standard care, and prevent hypoglycemia. In the CGM era, new treatment targets such as time in range should be considered in conjunction with HbA1c. One study using rtCGM demonstrated an increase of time in range compared to conventional treatment. rtCGM presents current glucose concentration data, as well as the direction and rate of change in glucose level every 1 to 5 minutes. This information enables development of new insulin dosing algorithms. This fine-tuning of insulin therapy should be based on healthy eating behavior. Furthermore, as the patient is the center of diabetes management patient education is needed regarding how this new technology can improve glucose management. This manuscript summarizes the utility of rtCGM for insulin adjustment.