Advances in Continuous Glucose Monitoring and Integrated Devices for Management of Diabetes with Insulin-Based Therapy: Improvement in Glycemic Control

Abstract

Continuous glucose monitoring (CGM) technology has evolved over the past decade with the integration of various devices including insulin pumps, connected insulin pens (CIPs), automated insulin delivery (AID) systems, and virtual platforms. CGM has shown consistent benefits in glycemic outcomes in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) treated with insulin. Moreover, the combined effect of CGM and education have been shown to improve glycemic outcomes more than CGM alone. Now a CIP is the expected future technology that does not need to be worn all day like insulin pumps and helps to calculate insulin doses with a built-in bolus calculator. Although only a few clinical trials have assessed the effectiveness of CIPs, they consistently show benefits in glycemic outcomes by reducing missed doses of insulin and improving problematic adherence. AID systems and virtual platforms made it possible to achieve target glycosylated hemoglobin in diabetes while minimizing hypoglycemia, which has always been challenging in T1DM. Now fully automatic AID systems and tools for diabetes decisions based on artificial intelligence are in development. These advances in technology could reduce the burden associated with insulin treatment for diabetes.

Navigating the Seas of Glycemic Control: The Role of Continuous Glucose Monitoring in Type 1 Diabetes Mellitus

“…Specifically, the study reports median TIR values of 64.20% (interquartile range [IQR], 51.73 to 72.43) and 62.80% (IQR, 55.00 to 71.90) after 30 and 90 days of use, respectively. Those results strengthen the evidence for the glucose-lowering efficacy of CGM in patients with T1DM [ 1 ]. CGM has the potential to offer patients not only monitoring data, but also educational information about their glucose response to specific meals and exercise.…”

“…Appropriate blood glucose monitoring (BGM) is the cornerstone of managing diabetes, especially for people with T1DM who need to use multiple insulin injections or insulin pumps, including automated insulin delivery systems. Continuous glucose monitoring (CGM) technology has progressively improved in terms of convenience and accuracy during the past decade, changing the paradigm of glycemic management by surpassing the limitations of average values and attempts to maintain optimal control within a range [ 1 ]. Previous clinical trials have shown that CGM systems have clinical benefits for patients who require intensive insulin therapy (especially those with T1DM), compared with traditional BGM [ 1 ].…”

“…Continuous glucose monitoring (CGM) technology has progressively improved in terms of convenience and accuracy during the past decade, changing the paradigm of glycemic management by surpassing the limitations of average values and attempts to maintain optimal control within a range [1]. Previous clinical trials have shown that CGM systems have clinical benefits for patients who require intensive insulin therapy (especially those with T1DM), compared with traditional BGM [1]. Therefore, real-time CGM (RT-CGM) or intermittent CGM (isCGM) is highly recommended for patients with diabetes who need multiple injections or continuous subcutaneous insulin infusions [2,3].…”

A Personalized Alert System for Air-quality Monitoring Based on Lung Functionality: An Observational Pilot Study

“…Personalized alert systems have increasingly played a vital role in chronic disease management, offering novel approaches to condition monitoring and real-time response mechanisms. In diabetes management, for instance, continuous glucose monitoring systems integrated with alert features have proven beneficial in facilitating timely intervention, thus enhancing glycemic control and reducing hypoglycemic episodes [20,21,24]. Similarly, in heart disease management, remote patient monitoring systems with personalized alert functions have shown potential in early detection of cardiac anomalies, reducing hospitalization rates, and improving patients' quality of life [22,23].…”

An Observational Pilot Study of a Tailored Environmental Monitoring and Alert System for Improved Management of Chronic Respiratory Diseases

“…In diabetes, continuous glucose monitors with alert features enhance glycemic control and reduce hypoglycemic episodes. 20 , 21 For heart disease, remote monitoring systems with personalized alerts aid in early cardiac anomaly detection, reducing hospitalizations and improving patient quality of life. 22 , 23 In respiratory diseases like asthma or COPD, smart inhalers and spirometers provide real-time feedback and personalized medication and lung function alerts, potentially transforming management.…”