Aim: The main objective of this observational study to assess the knowledge regarding continuous glucose monitoring (CGM) use among Physics of Bihar

Method: This was an observational survey conducted among physicians who carried a diabetic clinic and mostly treating both from of diabetes that is Type 1 Diabetes and Type 2 Diabetes in their clinical practice. A pre structured questionary was prepared to conduct the survey among 61 physicians across the Bihar state. Collected data was analysed by using statistical methods.

Result: 14% clinicians were well aware of CGM where as 66% were having poor knowledge and 20% were having no idea of the same. Among patients with type 2 diabetes The usage was higher for patients with type 1 diabetes (T2DM; 38/61, 62.3% vs 23/61, 37.7%; P<.001) by these physicians. The analysis also reveals that education, family income, diabetes type, age, duration of Diabetes and location were associated with CGM machine usage in adult patients (P<.05). The greatest difficulties to the physicians to use of CGM machine to manage diabetes patients include limited time (7/61, 11.4%), complicated operations (31/61, 50.8%), patients’ distrust (12/61, 19.7%), and cost (11/61, 18.1%).

Conclusion: The awareness and use of continuous glucose monitoring (CGM) in patients with diabetes and the proportion of physicians using CGM to manage their diabetes patients are low.

Keywords: Diabetes mellitus, CGM, surveys and questionnaires.

1. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329:977-986.
2. Boland E, Monsod T, Delucia M, Brandt CA, Fernando S, Tamborlane WV. Limitations of conventional methods of self-monitoring of blood glucose: lessons learned from 3 days of continuous glucose sensing in pediatric patients with type 1 diabetes. Diabetes Care 2001;24:1858-1862.
3. Kaufman FR, Austin J, Neinstein A, et al. Nocturnal hypoglycemia detected with the Continuous Glucose Monitoring System in pediatric patients with type 1 diabetes. J Pediatr 2002;141:625-630
4. Bode BW, Schwartz S, Stubbs HA, Block JE. Glycemic characteristics in continuously monitored patients with type 1 and type 2 diabetes: normative values. Diabetes Care 2005;28:2361-2366.
5. Klonoff DC. Continuous glucose monitoring: roadmap for 21st century diabetes therapy. Diabetes Care. 2005;28:1231–1239.
6. Deiss D. Bolinder J. Riveline J-P. Battelino T. Bosi E. Tubiana-Rufi N. Kerr D. Phillip M. Improved glycemic control in poorly controlled patients with type 1 diabetes using real-time continuous glucose monitoring. Diabetes Care. 2006; 29:2730–2732.
7. Diabetes Research in Children Network (DirecNet) Study Group. The accuracy of the Guardian RT continuous glucose monitor in children with type 1 diabetes. Diabetes Technol Ther. 2008;10:266–272.
8. The Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Continuous glucose monitoring and intensive treatment of type 1 diabetes. N Engl J Med. 2008;359:1464–1476.
9. Diabetes Research in Children Network Study Group. Continuous glucose monitoring in children with type 1 diabetes. J Pediatr. 2007;151:388–393.
10. Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403
11. Tuomilehto J, Lindstrom J, Eriksson JG et al (2001) Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 344:1343–1350
12. Peyrot M. Rubin RR. Patient-reported outcomes for an integrated real-time continuous glucose monitoring/insulin pump system. Diabetes Technol Ther. 2009;11:57–62.
13. Juvenile Diabetes Research Foundation Continuous Glucose Monitoring Study Group. Validation of Measures of Satisfaction with and Impact of Continuous and Conventional Glucose Monitoring. Diabetes Technol Ther. 2010 Sep; 12(9): 679–684.
14. Gibb I. Parnham A. Fonfrede M. Lecock F. Multicenter evaluation of Tosoh glycohemoglobin analyzer. Clin Chem. 1999;45:1833–1841.

Dr Amit Kumar Das

Diabetologist, Shree Hospital & Maternity, Muzaffarpur, Bihar