At Jothydev’s Diabetes Research Centre, in addition to blood glucose monitoring with glucometer, Continuous Glucose Monitoring (CGM) is also advised to selected diabetes patients since 2005. This study presented at the American Diabetes Association Scientific Convention at San Diego, California 2011, looks into the clinical application of CGM to improve the way diabetes is being treated. We assessed utility of CGM among type 2 diabetes patients on insulin, already practicing SMBG. 25 patients were enrolled (mean age=54yrs,SD=12.9; mean duration of diabetes=12yrs,SD=5.2), via convenience sampling based on ability and willingness to participate. 10 patients were on basal insulin + OHA and others on basal-bolus regimen + OHA. The study duration was 3-6 days.

A multi-disciplinary team of doctors, dieticians, pharmacist, and nurse educator made detailed analyses of CGM recordings. Observations included those missed in routine SMBG, like nocturnal hypoglycemia, glycemic excursions, Somogyi phenomenon etc. These observations were used for patient education, for changing number and type of insulin shots, duration and timing of exercise, timing of snacks and diet composition. In a few, where there was a compelling indication for a variable basal rate, insulin pump therapy was also advised .

The study suggested that CGM can unravel glycemic patterns hitherto undetected with SMBG in type 2 diabetes. Unlike in type 1 diabetes, the trends obtained by CGM  though abnormal are consistent over most of the days in type 2 diabetes providing the space for concrete treatment options and can thus supplement SMBG in routine diabetes treatment .