Due to increasing CGM accuracy, longer lasting glucose sensors and better reimbursement, CGM use is expanding. Yet there is still room for improvement in glucose management across all types of diabetes. One strategy to enhance CGM effectiveness is to establish clear targets for CGM metrics that diabetes care teams and people with diabetes can work together to achieve. Professional diabetes associations recently endorsed accepted core CGM metrics. The International Consensus on TIR targets, convened in February 2019, proposes clear CGM targets for time-in-range, time-below-range and time-above-range to help guide safe and effective therapy. The proposed CGM targets, based on data from large pre-CGM clinical trials and CGM randomized controlled trials, are shown in the Table. The group recommends a standardized CGM report incorporating key CGM metrics and targets along with a 14-day composite glucose profile to be an integral component of clinical decision making. The ambulatory glucose profile (AGP) represents such a standard CGM report. When patients endeavor to reach the proposed TIR targets, particularly for children and adolescents, one should emphasize that each 5% incremental increase in TIR is clinically beneficial. The CGM targets and standardized profile proposed by the International TIR Consensus may facilitate the routine use of CGM and improve clinical outcomes of diabetes management.
T. Battelino: Advisory Panel; Self; Eli Lilly and Company, Medtronic, Novo Nordisk A/S, Sanofi. Consultant; Self; Eli Lilly and Company, Sanofi. Research Support; Self; JDRF, National Institute of Diabetes and Digestive and Kidney Diseases. Speaker’s Bureau; Self; Abbott, Eli Lilly and Company. Stock/Shareholder; Self; DreaMed Diabetes. T. Danne: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly Diabetes, Medtronic, Novo Nordisk A/S, Roche Diabetes Care, Sanofi-Aventis. Speaker’s Bureau; Self; Dexcom, Inc. M. Phillip: Consultant; Self; Qulab Medical, RSP Systems A/S. Research Support; Self; Bristol-Myers Squibb Company, Dexcom, Inc., JDRF, Lexicon Pharmaceuticals, Inc., Merck #x0026; Co., Inc., OPKO. Stock/Shareholder; Self; DreaMed Diabetes, Ltd., NG Solutions Ltd., Nutriteen Professional Ltd. Other Relationship; Self; AstraZeneca, Eli Lilly and Company, Insulet Corporation, Medtronic MiniMed, Inc., Novo Nordisk A/S, Pfizer Inc., Sanofi-Aventis.
Advanced Technologies and Treatments for Diabetes
