Clinical update on insulin pump therapy in combination with continuous glucose monitoring.

Department for Endocrinology, Diabetes and Vascular Medicine, Academic Teaching Hospital Munich Bogenhausen, Munich, Germany. thorsten_siegmund@gmx.de

Minerva endocrinologica 2013 Jun

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In recent years, the treatment of type 1 diabetes has changed significantly. An important diagnostic and therapeutic support tool is the continuous glucose monitoring (CGM) showing its best performance when used in combination with an insulin pump therapy. Before the availability of CGM the consideration of glucose regulation and therapeutic success was based solely on selectively measured blood glucose levels and HbA1c. In contrast to the blood glucose measurements CGM measures in the interstitial fluid and opens a new dimension of diabetes therapy, we call it "glucose dynamics". The knowledge of the continuous glucose course and its trends has proved to be a highly relevant additional parameter which in practical terms has a particularly stabilizing influence on blood glucose profiles. CGM therefore offers the option of a fine-tuning of metabolic control by experienced heath care professionals and the patient, making blood glucose control in general and unplanned activities and problems in everyday life better controllable. However, despite the tremendous potential of CGM in combination with a pump therapy the basic settings of an effective pump therapy are crucial. Particularly the right basal insulin coverage as the first step is the key issue for success. With support of CGM there is an enormous potential to facilitate the adjustment and optimization of insulin pump therapy.

Citation

T Siegmund, R Kolassa, A Thomas. Clinical update on insulin pump therapy in combination with continuous glucose monitoring. Minerva endocrinologica. 2013 Jun;38(2):133-43