Guidelines Needed for Interpreting Continuous Glucose Monitoring Reports in those Without Diabetes
With the Food and Drug Administration now allowing for the over-the-counter purchase of continuous glucose monitor (CGM)—small sensors that penetrate the skin to measure glucose levels in real time—there is high consumer interest in use of these devices for health and wellness even among people without diabetes. However, a new study led by researchers from Boston University Chobanian & Avedisian School of Medicine has found there is no consensus in how clinical experts interpret CGM reports from people without this disease.
Nicole Spartano“This should be a wake-up call that research needs to be done that will inform creation of guidelines for clinical interpretation of CGM for patients without diabetes,” says corresponding author Nicole Spartano, assistant professor of medicine.
The researchers surveyed specialists who care for patients with complex diabetes (and only rarely treat individuals without diabetes) and asked them to evaluate 20 potentially challenging DexcomG6 Pro CGM reports (hemoglobin A1c [HbA1c] and fasting venous glucose levels) from individuals without diabetes. The clinicians then reported whether they would recommend follow-up and the reasoning for their decision.
Upon review of their responses, the researchers found high discordance among expert clinicians on interpreting potentially challenging CGM reports for people without diabetes highlighting the need for more research in developing normative data for people without diabetes. “Our results suggest that even clinicians with extensive CGM experience do not agree with one another on how they interpret or provide follow-up recommendations for individuals without diabetes based on CGM data.”
According to Spartano, more individuals without diabetes are becoming interested in tracking their glucose levels using CGM. “Motivations for CGM wear in these individuals are diverse and include a desire to promote healthy behaviors and avoid prediabetes/
diabetes. While CGM sensors have not been approved to diagnose or predict prediabetes or diabetes, this possible application holds promise for the future.”
In the absence of specific guidelines for CGM interpretation in those without diabetes, Spartano believes physicians with continuous glucose monitoring expertise can help advise on CGM data interpretation in this new population.
These findings appear online in the Journal of Diabetes Science and Technology.