Response to Comment on Wong et al. Real-Time Continuous Glucose Monitoring Among Participants in the T1D Exchange Clinic Registry. Diabetes Care 2014;37:2702–2709

We thank Price et al. (1) for their comments on our recent article exploring use of continuous glucose monitoring (CGM) in the T1D Exchange Clinic Network registry (2). We acknowledge, as we did in the original article, that the experience of participants included in our study was based on older generations of CGM devices and agree with Price et al. that newer generations of devices may be used differently. We are grateful that the authors highlighted the fact that readers should not necessarily use our results to draw conclusions about CGM use with newer generations of the technology and are in agreement that different CGM systems can impact value and use.

However, we do feel that there is merit in reporting use of CGM with older systems in order to describe the state of use at the time when CGM was first widely available to patients. As Price et al. also discuss, we did not distinguish between types of devices in our report as our intent was to describe CGM use as a whole. A preliminary analysis showed no significant differences in frequency of use of the different brands of CGM systems used at the time. Certainly, we agree that newer, more accurate systems should be studied in future research and distinguishing between types of systems is relevant if there are significant differences; however, these systems are improving so rapidly it is difficult to collect this type of user data and report it before the technology studied is out of date. Yet, knowledge of the frequency of use, the valued features of older generations of devices, and experiences with older technologies should not be completely ignored but instead used as an important baseline data to determine and identify the benefit of newer, more reliable CGM in type 1 diabetes.