ADA 2019—New recommendations for continuous glucose monitoring


  • Emily Willingham, PhD
  • Conference Reports
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Takeaway

  • The International Consensus on time-in-range (TIR) targets offers a table of its recommendations for continuous glucose monitoring (CGM), based on data from large pre-CGM clinical trials and randomized controlled trials of CGM.

Why this matters

  • Use of CGM is growing, necessitating its effective incorporation into management to set appropriate targets.
  • This consensus report has endorsements from several groups, including the American Diabetes Association and European Association for the Study of Diabetes.

Key recommendations

  • Use a standardized CGM report (e.g., ambulatory glucose profile) that includes key metrics.
  • Report should also include a 14-day composite glucose profile.
  • Especially with younger patients, make clear that each 5% increase in TIR offers benefit.
  • If targets are easy to attain, especially with lifestyle changes, they say, there is no need to raise them for patients at/near normal range.
  • A table of proposed targets for patients with type 1 and type 2 diabetes, those who have frailty, and pregnant populations is available here. 
  • Recommended target range for type 1 or 2 diabetes: 70-180 mg/dL (3.9-10.0 mmol/L).
  • Recommendation during pregnancy: 63-140 mg/dL (3.5-7.8 mmol/L).
  • Set conservative targets for older or high-risk people, focusing on time spent