Table 1.
Headings | Specific questions |
---|---|
1. Clinical relevance of HbA1c in monitoring | (a) HbA1c limit should be set person to person rather than a generalized limit. |
(b) Use A1c and other variables along with CGM for more accurate results. | |
(c) HbA1c values have limitations. | |
2. Clinical controversies of HbA1c | (a) Discrepancy b/w calculated eA1c and HbA1c. (b) SMBG fails to detect nocturnal and asymptomatic hypoglycemia (sporadic nature). |
(c) Hypoglycemia is not regularly measured when you are using HBA1c. | |
3. CGM used in TD1 than TD2 | (a) Use of CGM in patients with TD1 causes a major decrease in the HbA1c levels. |
(b) Lack of studies for TD2: More real-time data needed because helpful for TD2. | |
4. Limitations of CGM in clinical practice | (c) Insufficient data for adjustment of treatment regimen. |
(d) For patients on oral therapy or insulin therapy, hypoglycemia measurement is EVEN MORE important. | |
(e) CGM is expensive, hence limited use. | |
5. Patient perception on CGM | (f) Patient inconvenience with SMBG vs. CGM. |
(g) CGM is user friendly. | |
(h) CGM is less time consuming. | |
6. Future implications of CGM | (i) Pregnant women with diabetes mellitus also benefit from CGM. |
(j) Comorbidities should be considered: Not enough studies on comorbidities. | |
(k) May be used for TD2 for therapy decisions. | |
(l) How involved insurance companies will be? | |
7. Glucose variability | Literature reported |
HbA1c = glycated hemoglobin, CGM = continuous glucose monitoring, TD1 = type 1 diabetes mellitus, TD2 = type 2 diabetes mellitus, eA1c = estimated A1C, SMBG = self-monitoring of blood glucose