Page 0024



Proof of positive impact of CGM for

diabetics on injections was shown via the

DIaMonD study (Multiple Daily Injections

and Continuous Glucose Monitoring in

Diabetes), the first-of-its-kind study that

demonstrated the impact of CGM on

HbA1c and hypoglycemia in participants

on a multiple daily injection (MDI) insulin

regimen. Published in January 2017

in Journal of the American Medical

Association (JAMA), the study showed

Dexcom CGM System users on MDI

achieved a 1% average reduction in

HbA1c after 24 weeks of regular use.

In addition to better glucose control,

participants also increased time spent in

target range and spent less time in hypo

and hyperglycemia, compared to those

using a meter to monitor their glucose.

Furthermore, news that costs for

using Dexcom G6 are to be covered by

US health insurers is also proof that CGM

works. The system will be covered for

Medicare beneficiaries, having met the

category requirements for therapeutic

CGM systems by the US Centers for

Medicare & Medicaid Services (CMS).

Coverage for therapeutic CGM includes

certain beneficiaries who have either

Type 1 or Type 2 diabetes and intensively

manage their insulin. The company

expects to begin

shipping product

to Medicare

customers in the

first part of 2019.

NHS England's

Long Term Plan,

published in early

January, included

news that within two

years all pregnant

women living in England with Type 1

diabetes will be provided with CGM

sensors. The announcement follows

a JDRF-funded international study of

pregnant women that was the first to

confirm the benefits of CGM use during

pregnancy. It provided crucial evidence

that pregnant women with Type 1

diabetes using the device had better

blood glucose control as a result as well

as healthier babies.

JDRF and partner organisations

submitted this evidence to England's

National Institute for Health and Care

Excellence (NICE). NICE subsequently

agreed to update its Diabetes in

Pregnancy Guidelines with a focus on

CGMs. It is as yet unconfirmed whether

NHS bodies in Scotland, Wales and

Northern Ireland will follow suit.

The JDRF-funded international

study in 2017 that first confirmed the

benefits of CGMs during pregnancy

was named CONCEPTT and was

published in The Lancet.

To download JDRF's toolkit, click the



It should be noted that closed loop

pumps work off sensor data - essentially

these will be the pumps of the future. Very

newly available in the UK is Medtronic

MiniMed 670g closed loop insulin delivery

system, which can be set to automatically

deliver or suspend insulin based on

readings from an Enlite CGM sesnsor.

See the extended feature in the last issue

by clicking on the front cover image.

Also, this month American company

Beta Bionics announced it had gained

further funding for its iLet 'bionic pancreas'

for people with Type 1 diabetes. Using

machine learning and data from a CGM

device, the algorithms calculate and dose

insulin and/or glucagon as needed.

So, as pump technology progresses,

the need for CGM sensor usage becomes

embedded in future solutions to improved

diabetes control via wearable tech.

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