Professional CGM

What is Professional CGM?

What is Professional CGM?

Professional CGM for better insights into patient glucose control

 

Professional CGM Professional CGM technology helps clinicians gain more complete insights into their patients' glycemic profiles. When used to make therapy and lifestyle recommendations, Professional CGM data can lead to improved glucose control. Professional CGM works as follows:

 

  • Devices are owned by healthcare professionals and are used for "blinded" or "masked" collection of glucose data.
  • Patients wear the device for up to 6-days and return it to the office for download.
  • Patients do not receive glucose alerts and only see the CGM data after it's been analyzed by the healthcare professional.1

1AACE Continuous Glucose Monitoring Task Force. AACE Consensus Statement on CGM. Endocrine Practice. 2010;16(5):730-744.
 

What is Professional CGM?

Meter readings suggest good glucose control

CGM Reveals Insights Beyond BGs and A1C
When measurements are taken infrequently, one can miss vital data points.

CGM takes readings every 5 minutes 24 hours a day over several consecutive days, providing a more accurate understanding of blood glucose readings than infrequent BG meter readings.

 

What is Professional CGM?

What are the components for use?

Sensor
Sensor
The sensor is inserted into interstital fluid and continuously generates an electrical current proportional to the glucose concentration.

iPro2 Recorder
iPro2 Recorder
Digitally stores the average sensor current every 5 minutes.

Dock wired to PC with CareLink iPro
Dock wired to PC with CareLink® iPro
After the study is complete, data from iPro2 is uploaded through Dock to PC with Internet connection to CareLink iPro.

CareLink iPro Reports
CareLink iPro Reports
CareLink iPro applies a retrospective algorithm to calibrate sensor current using BG meter readings to generate reports.

 

What is Professional CGM?

iPro2 is labeled for all patients with diabetes

"The iPro2 digital recorder is intended to continuously record interstitial glucose levels in persons with diabetes mellitus.

The information may allow identification of patterns of glucose-level excursions above and below a desired range, facilitating therapy adjustments, which may minimize these excursions."*

*iPro2 User Guide MP8025420-013_a
 

What is the scientific evidence?

What is the scientific evidence?

Professional CGM revealed up to 7x more night-time excursions than BG meters.

Study Design

  • 47 patients (A1C > 8.0%), intensive insulin therapy.*
  • 3-day Pro CGM evaluation and blood glucose (BG) meter readings.*
  • Compared highs and lows identified with Professional CGM and BG meters.
Outcome

Published: Kaufman F, et. al. Diabetes Care. 2001;24(12):2030 – 2034. Adapted from Kaufman study.
*Sof-sensor
 

What is the scientific evidence?

Professional CGM leads to bolus/basal therapy modifications

Study Design
  • 35 type 1 pediatric patients with management issues
  • Recorded therapy modifications using Professional CGM
Outcome

  • Therapy Modifications

Published: Kaufman F, et. al. Diabetes Care. 2001;24(12):2030 – 2034. Adapted from Kaufman study.
 

What is the scientific evidence?

Professional CGM reveals postprandial hyperglycemia

Study Design

  • 56 type 1 pediatric patients, A1C 7.7%
  • Near target pre-meal glucose
Outcome

  • 90% experienced glucose levels > 180 mg/dL
  • Nearly 50% experienced glucose levels > 300 mg/dL

Boland E, et al. Limitations of conventional methods of self-monitoring of blood glucose. Diabetes Care. 2001;24:1858-1862.
 

What is the scientific evidence?

Professional CGM reduces the duration of hypoglycemic events

Study Design

  • 109 adults with insulin-treated diabetes
Outcome

  • While both groups achieved A1C reductions, only the Professional CGM group enjoyed significantly shorter hypo events


Clinicians can use Professional CGM to guide therapy adjustments that can improve glycemic control without increasing the risk of hypoglycemia.

Tanenberg R, et al. Use of the Continuous Glucose Monitoring System to Guide Therapy in Patients With Insulin-Treated Diabetes: A Randomized Controlled Trial. Mayo Clinic Proceedings. 2004;79(12):1521-1526.
 

What is the scientific evidence?

Professional CGM data can help reduce risk of macrosomia

Study Design

  • 71 pregnant women with type 1 or type 2
Outcome

  • Lower A1C in third trimester
  • Reduced risk of macrosomia


When used as an educational tool during pregnancy, Professional CGM is associated with improved glycemic control and reduced risk of macrosomia.

*Murphy HR, et al. Effectiveness of continuous glucose monitoring in pregnant women with diabetes: randomised clinical trial. BMJ. 2008;337: a1680. Adapted from Murphy study.
 

What is the scientific evidence?

Professional CGM captures more hypoglycemic episodes vs. BG meters

Study Design

  • 40 elderly patients
  • Mean age = 75
  • 70% Type 2, 30% type 1
  • Avg. A1C = 9.3%
  • Therapy distribution:
  • Insulin only = 35%
  • Insulin + Orals = 38%
  • Orals = 8%
  • 3 days of Professional CGM
Outcome


93% of hypoglycemic episodes were unrecognized by BG meter or symptoms.

*Munshi M, Segal A, et. al. hypoglycemia among elderly patients with poor glycemic control. Arch Intern Med. 2011; 171(4):362 - 364. Adapted from Munshi study.
 

What is the scientific evidence?

What is the average accuracy for iPro2?

Adult
9.9%
Children
10.1%

 


How Does iPro2 achieve this accuracy?

  • iPro2 interpolates between past and future meter readings using a retrospective algorithm to calculate a calibration factor that optimizes sensor accuracy.
  • This is currently impossible for real-time systems using the same sensor. Real-time systems can only use meter readings from the past.

1Welsh J, et al. J Diabetes Sci Technology. 2012; Letter to the Editor. 475-476. MARD data based on a recent Medtronic retrospective analysis of iPro2 algorithms.

Why should Professional CGM be a part of your practice?

The value of Professional CGM

  • Professional CGM is physician-owned.
  • Professional CGM is labeled for people living with diabetes age 18 or older.
  • Professional CGM uncovers glucose characteristics missed by BG meters.
  • Nocturnal Lows, Dawn Phenomenon, Post-Prandial Highs, Total Glucose Excursion
  • Professional CGM studies lead to:
  • Reduced A1C without increased hypoglycemia1
  • Identification of more nocturnal hypoglycemic episodes than anticipated2
  • Identification of dramatically more glucose variability than previously expected
  • 1Kaufman F, Gibson L, Halvorson M, et al. A pilot study of the continuous glucose monitoring system. Diabetes Care.2001; 24(12):2030–2034.
    2Levetan C, Want LL, Weyer C, et al. Impact of pramlintide on glucose fluctuations and postprandial glucose, glucagon, and triglyceride excursions among patients with type 1 diabetes intensively treated with insulin pumps. Diabetes Care. 2003;261-268.
 
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