Background and Aims

Continuous glucose monitoring (CGM) may help to improve diabetes therapy. An international consensus paper calls for standards in the CGM data analysis. The aim of this study is to evaluate the CGM-based clinical targets in italian adult patients with Type1 (DM1) and Type2 (DM2) diabetes using an IS-CGM (intermittently scanned CGM - FreeStyle Libre^TM system).

Methods

We evaluate data of 227 patients (130 DM2; 97 DM1) using IS-CGM for at least 4 weeks. All patients were treated with insulin (basal-bolus regimen). Data were obtained from the cloud-based management system LibreView®.

Results

The DM1 patients showed: mean glucose level 183 ± 45 mg/dl; 8.7 scans per day; mean time in range (70-180 mg/dl, TIR) 49.8% ± 19, time below range (TBR) 4.8% and an estimated HbA1c of 8.1%±1.4. 17% of patients had TIR ≥ 70%.

The DM2 patients showed mean glucose level 162 ± 31.7 mg/dl, 5 scans per day, TIR 63.2% ± 18, TBR 3.1% and an estimated HbA1c 7.2%±0.8. 33% of patients had TIR ≥ 70%.

The TIR increased with the number of scans per day in the DM1 patients: scans/day < 4: TIR 35.7% ± 17 ; scans/day 4-6 : TIR 49.4 %± 17; scans/day >6: TIR 54.0 %± 10 (p<0.05). There were no differences in DM2 patients with the increased numbers of scans per day.

Conclusions

Our study show that it is difficult to achieve the clinical targets identified by the international consensus without specific patient's education in using and interpretation the IS-CGM data.