Building Competency in Diabetes Education THE ESSENTIALS

MONITORING| 7-5 Diabetes: Update 2021 (1). The information discussed in this chapter is primarily in reference to adults with diabetes.

New Terminology

Blood glucose monitoring has come a long way from the 1980’s when blood glucose meters were initially introduced for personal use. Those early meters were a revelation in their time just as the continuous glucose monitoring devices have been a revelation in our time. And there is more to come. To help clarify and identify the differences in the various glucose monitoring modalities we have available today and to make room for further developments, new terminology is now being used.

Table 1, New Terminology adapted from the 2021 CPG Monitoring Update (1). New Term Old Term Definition Capillary blood glucose (CBG) Self-monitored blood glucose (SMBG)

Finger prick for capillary blood glucose sample Interstitial glucose samples measured intermittently with sensing device Interstitial glucose samples continuously being measured and data transmitted for viewing at any time Interstitial glucose samples with data collected and stored for later viewing

Intermittently scanned continuous glucose monitoring (isCGM)

Flash glucose monitoring (FGM)

Real-time continuous glucose monitoring (rtCGM)

Continuous glucose monitoring

Masked continuous glucose monitoring (mCGM)

Professional continuous glucose monitoring

This new terminology reflects the various methods we are currently using to measure glycemic management. Although the A1c remains a primary indicator for blood glucose control its limitations as to glucose variability and immediate feedback have led to the popular use of both real time continuous glucose monitoring (rtCGM) and intermittent scanning continuous glucose monitoring (isCGM). The A1c and capillary blood glucose are direct blood samples whereas the rtCGM and isCGM use interstitial fluid samples. An entire scientific field has developed attempting to integrate the data from these modalities to give us a clear picture of glycemic management. It is difficult to keep abreast of all the latest technology available to measure the blood glucose. However as diabetes educators we can assist the patient with setting appropriate glycemic targets and help them interpret the data to make informed decisions. It is important to remember that it is not the act of measuring the blood glucose that is crucial, it is what the patient does with the results.