The Singapore Family Physician

Back to issue Vol 50 No. 6 - Continuous Glucose Monitoring

Getting Started with Continuous Glucose Monitoring: From Guidelines to Implementation

Ester Yeoh
The Singapore Family Physician Vol 50 No 6 - Continuous Glucose Monitoring
11 - 17
31 May 2024
0377-5305
Glycated haemoglobin (HbA1c) is widely recognised as the primary tool for evaluating glycaemic control in people living with diabetes (PwD), but it does not assess day-to-day diabetes control, glycaemic variability, acute glycaemic variations, or hypoglycaemia. Day-to-day tools used for measuring glycaemic markers, such as self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM), complement HbA1c to provide a complete picture of the individual’s glycaemic control. The use of CGM has improved the quantity and quality of glycaemic information available to PwD and clinicians, enabling rapid review to facilitate informed decisions in treatment adjustment and lifestyle management. Although the use of CGM to monitor people with type 1 diabetes mellitus or insulin-treated type 2 diabetes mellitus (T2DM) has been increasingly incorporated into international and regional guidelines, it remains underutilised in clinical practice for T2DM. In this article, data from the recent Asia Pacific consensus on CGM, existing literature, and clinical experience are used to provide guidance on the appropriate use of CGM in the T2DM population in Singapore. We recommend CGM in individuals with T2DM on either intensive insulin therapy or basal insulin with suboptimal glycaemic control, as well as for certain special subgroups, such as the elderly. We also discuss solutions to overcome common challenges faced during initiation of CGM and provide clinicians with a simplified approach for interpreting and reviewing data from the Ambulatory Glucose Profile report generated from CGM use.