Glycemic Status Assessment by the Latest Glucose Monitoring Technologies

Abstract

The advanced and performing technologies of glucose monitoring systems provide a large amount of glucose data that needs to be properly read and interpreted by the diabetology team in order to make therapeutic decisions as close as possible to the patient's metabolic needs. For this purpose, new parameters have been developed, to allow a more integrated reading and interpretation of data by clinical professionals. The new challenge for the diabetes community consists of promoting an integrated and homogeneous reading, as well as interpretation of glucose monitoring data also by the patient himself. The purpose of this review is to offer an overview of the glycemic status assessment, opened by the current data management provided by latest glucose monitoring technologies. Furthermore, the applicability and personalization of the different glycemic monitoring devices used in specific insulin-treated diabetes mellitus patient populations will be evaluated.

Keywords: ambulatory glucose profile (AGP); continuous glucose monitoring (CGM); integrated glycemic state (IGS).

Figure 1

Integrated glycemic state (IGS) in four different conditions. IGS includes the point value of blood glucose, the trend arrow that indicates the direction and speed towards which blood glucose is moving, glucose profile of the previous hours/days. The same IGS can occur in four different conditions: pre-meal in the presence of physical activity, pre-meal in the absence of physical activity, post-meal in the presence of physical activity, post-meal in the absence of physical activity. For each condition the patient will be able to make different therapeutic decisions based on IGS.

Figure 2

(A) Data sharing. The patient, identified as “sending member”, shares its own glucose profile data with the healthcare professionals, identified as the “receiving member”. (B) Data sharing: circular flow. The patient supported on the management of the diabetes by family members, cohabitants and caregivers, that we identify as “sending community”, shares glucose profile data with the multidisciplinary diabetes team, that we identify as “receiving community”, according to a model that we propose to call “circular flow”. The members of the sending community can be themselves receiving members.