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Battelino T, Danne T, Bergenstal RM et al. "Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations from the International Consensus on Time in Range." Diabetes care (2019): 1-11.
Updated Standards of Medical Care in Diabetes from ADA
On July 31, 2019, the American Diabetes Association released updated standards of medical care, with changes focusing on new metrics and reporting of continuous glucose monitoring (CGM) data, and new medication options. The glucose monitoring update was prompted by the publication of by a broadly endorsed set of recommendations of the International Consensus on Time in Range (Battelino T, Danne T, Bergenstal RM, et al. Diabetes Care 2019 Jun 8). The ADA standards of medical care now provide guidance on standardized CGM metrics (see NEW Table at https://care.diabetesjournals.org/table_6.4_New). To make these metrics more actionable, standardized reports with visual cues, such as the Ambulatory Glucose Profile (see NEW Figure of AGP https://care.diabetesjournals.org/content/diacare/42/8/1593/F2.large.jpg) are recommended and may help the patient and the provider interpret the data and use it to guide treatment decisions.
Notably the ambulatory glucose profile report (AGP Report) was developed by the International Diabetes Center and is now being used across the globe to evaluate CGM data. More details here: https://care.diabetesjournals.org/content/42/Supplement_1/S61 or www.AGPreport.org.
1. Johnson, Mary L., et al. "Utilizing the Ambulatory Glucose Profile to Standardize and Implement Continuous Glucose Monitoring in Clinical Practice." Diabetes technology & therapeutics 21.S2 (2019): S2-17-25.
2. Richard M., et al. "Glucose management indicator (GMI): a new term for estimating A1C from continuous glucose monitoring." Diabetes care 41.11 (2018): 2275-2280.
3. Beck, Roy W., et al. "The Relationships Between Time in Range, Hyperglycemia Metrics, and HbA1c." Journal of diabetes science and technology (2019): 1932296818822496.
4. Beck, Roy W., et al. "Validation of time in range as an outcome measure for diabetes clinical trials." Diabetes care 42.3 (2019): 400-405.
1. Danne T, Nimri R, Battelino T, Bergenstal RM, Close KL, DeVries JH, ... & Beck R. (2017). International consensus on use of continuous glucose monitoring. Diabetes care, 40(12), 1631-1640.
2. Riddle MC, Gerstein HC, and Cefalu WT. "Maturation of CGM and Glycemic Measurements Beyond HbA1c—A Turning Point in Research and Clinical Decisions." Diabetes Care 40.12 (2017): 1611-1613.
3. Petrie JR., Peters AL, Bergenstal, RM, Holl RW, Fleming GA., & Heinemann L. (2017). Improving the clinical value and utility of CGM systems: issues and recommendations. Diabetologia, 60(12), 2319-2328.
4. Buckingham BA, Close KL, Bergenstal RM, Danne T, Grunberger G, Kowalski AJ, Peters A, Heller SR (2017). Reaching an International Consensus on Standardizing Continuous Glucose Monitoring (CGM) Outcomes―Aligning Clinicians, Researchers, Patients, and Regulators. American Diabetes Association 77th Scientific Meeting, June 2017, San Diego, CA.
Drs. Fonseca and Grunberger, Co-Chairs of AACE/ACE Consensus Conference Writing Committee submitted a letter to the editor of Endocrine Practice noting that AACE supports "making the AGP report standard across all platforms (diabetes devices and diabetes data management software)." The AGP report as standard, is also being added to the AACE CGM Consensus Conference Statement. Link to full letter. Vivian Fonseca and George Grunberger (2017) LETTER TO THE EDITOR. Endocrine Practice: May 2017, Vol. 23, No. 5, pp. 629-632. doi: http://dx.doi.org/10.4158/1934-2403-23.5.629