Self-monitoring of blood glucose (SMBG) is an important part of diabetes management but only provides a snapshot view of the blood sugar at that point in time. Technology such as Freestyle Libre and Continuous Glucose Monitoring (CGM) provides blood glucose readings and trends whilst omitting the more traditional method of multiple daily blood testing, and they have been reported in clinical trials to reduce hypoglycaemia, and improve blood sugar management day to day. This is a life changing technology to improve their quality of life and improve management of their blood sugar levels. The advantage of technology is the availability of information about glucose levels which helps to predict hyper and hypoglycaemia and to adjust the insulin doses accordingly. NICE guidelines NG18 recommend that children and young people with T1DM and persistent problems with hypoglycaemia unawareness or repeated hyper or hypoglycaemia should be offered CGM. A Cochrane meta-analysis showed that CGM technology can reduce HbA1C level without increase in the risk of hypoglycaemia. Aspects of CGM/Libre technology may impact upon its accuracy such as MARD (Mean Absolute Relative Difference), accuracy of glucose trend, sensitivity & specificity, measuring stability, calibration and the lag time. Barriers of usage should be addressed and education is vital. This presentation will focus on the following:
Understanding use of CGM/Libre and its limitations.
Effects of CGM on metabolic control, fear and frequency of hypoglycaemic episodes.
Use a systematic approach to interpretation of analyses.
27 - 29 Nov 2019
British Society for Paediatric Endocrinology and Diabetes