TY - JOUR
T1 - Role of continuous glucose monitoring in diabetic patients at high cardiovascular risk: an expert-based multidisciplinary Delphi consensus
AU - Di Mario, Carlo
AU - Di Mario, Clara
AU - Genovese, Stefano
AU - Lanza, Gaetano Antonio
AU - Mannucci, Edoardo
AU - Marenzi, Giancarlo
AU - Sciatti, Edoardo
AU - Pitocco, Dario
AU - Avogaro, Angelo
AU - Bertuzzi, Federico
AU - Bertuzzi, Paolo Francesco
AU - Bonora, Enzo
AU - Borghi, Claudio
AU - Buzzetti, Raffaella
AU - Carugo, Stefano
AU - Capodanno, Davide
AU - Consoli, Agostino
AU - Conti, Antonio
AU - Danesi, Rossella
AU - Bartolo, Paolo
AU - Ferrari, Gaetano Maria De
AU - Favale, Stefano
AU - Giorda, Carlo
AU - Giorgino, Francesco
AU - Girelli, Angela
AU - Girelli, Alberto
AU - Golino, Paolo
AU - Grigioni, Francesco
AU - Indolfi, Ciro
AU - Irace, Concetta
AU - Lovati, Elisabetta
AU - Maffettone, Ada
AU - Masulli, Maria
AU - Oliva, Fabrizio G
AU - Oltrona Visconti, Luigi
AU - Orsi, Emanuela
AU - Orsi, Cosma Emilio
AU - Pagotto, Uberto
AU - Paloscia, Leonardo
AU - Parati, Gianfranco
AU - Perrone, Pasquale
AU - Perrone, Pia Alba Gloria
AU - Piccirillo, Gianfranco
AU - Pozzilli, Paolo
AU - Pugliese, Giuseppe
AU - Purrello, Francesco
AU - Ribichini, Flavio
AU - Rubboli, Andrea
AU - Senni, Michele
AU - Trevisan, Roberto
AU - Tubili, Claudio
AU - Uguccioni, Massimo
PY - 2022
Y1 - 2022
N2 - Background: Continuous glucose monitoring (CGM) shows in more detail the glycaemic pattern of diabetic subjects and provides several new parameters (“glucometrics”) to assess patients’ glycaemia and consensually guide treatment. A better control of glucose levels might result in improvement of clinical outcome and reduce disease complications. This study aimed to gather an expert consensus on the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk or with heart disease. Methods: A list of 22 statements concerning type of patients who can benefit from CGM, prognostic impact of CGM in diabetic patients with heart disease, CGM use during acute cardiovascular events and educational issues of CGM were developed. Using a two-round Delphi methodology, the survey was distributed online to 42 Italian experts (21 diabetologists and 21 cardiologists) who rated their level of agreement with each statement on a 5-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with any given statement. Results: Forty experts (95%) answered the survey. Every statement achieved a positive consensus. In particular, the panel expressed the feeling that CGM can be prognostically relevant for every diabetic patient (70%) and that is clinically useful also in the management of those with type 2 diabetes not treated with insulin (87.5%). The assessment of time in range (TIR), glycaemic variability (GV) and hypoglycaemic/hyperglycaemic episodes were considered relevant in the management of diabetic patients with heart disease (92.5% for TIR, 95% for GV, 97.5% for time spent in hypoglycaemia) and can improve the prognosis of those with ischaemic heart disease (100% for hypoglycaemia, 90% for hyperglycaemia) or with heart failure (87.5% for hypoglycaemia, 85% for TIR, 87.5% for GV). The experts retained that CGM can be used and can impact the short- and long-term prognosis during an acute cardiovascular event. Lastly, CGM has a recognized educational role for diabetic subjects. Conclusions: According to this Delphi consensus, the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk is promising and deserves dedicated studies to confirm the experts’ feelings.
AB - Background: Continuous glucose monitoring (CGM) shows in more detail the glycaemic pattern of diabetic subjects and provides several new parameters (“glucometrics”) to assess patients’ glycaemia and consensually guide treatment. A better control of glucose levels might result in improvement of clinical outcome and reduce disease complications. This study aimed to gather an expert consensus on the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk or with heart disease. Methods: A list of 22 statements concerning type of patients who can benefit from CGM, prognostic impact of CGM in diabetic patients with heart disease, CGM use during acute cardiovascular events and educational issues of CGM were developed. Using a two-round Delphi methodology, the survey was distributed online to 42 Italian experts (21 diabetologists and 21 cardiologists) who rated their level of agreement with each statement on a 5-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with any given statement. Results: Forty experts (95%) answered the survey. Every statement achieved a positive consensus. In particular, the panel expressed the feeling that CGM can be prognostically relevant for every diabetic patient (70%) and that is clinically useful also in the management of those with type 2 diabetes not treated with insulin (87.5%). The assessment of time in range (TIR), glycaemic variability (GV) and hypoglycaemic/hyperglycaemic episodes were considered relevant in the management of diabetic patients with heart disease (92.5% for TIR, 95% for GV, 97.5% for time spent in hypoglycaemia) and can improve the prognosis of those with ischaemic heart disease (100% for hypoglycaemia, 90% for hyperglycaemia) or with heart failure (87.5% for hypoglycaemia, 85% for TIR, 87.5% for GV). The experts retained that CGM can be used and can impact the short- and long-term prognosis during an acute cardiovascular event. Lastly, CGM has a recognized educational role for diabetic subjects. Conclusions: According to this Delphi consensus, the clinical and prognostic use of CGM in diabetic patients at high cardiovascular risk is promising and deserves dedicated studies to confirm the experts’ feelings.
KW - Cardiovascular outcome
KW - Continuous glucose monitoring
KW - Time in range
KW - Glucometrics
KW - Glycaemic variability
KW - Delphi method
KW - Cardiovascular outcome
KW - Continuous glucose monitoring
KW - Time in range
KW - Glucometrics
KW - Glycaemic variability
KW - Delphi method
UR - http://hdl.handle.net/10807/228307
U2 - 10.1186/s12933-022-01598-2
DO - 10.1186/s12933-022-01598-2
M3 - Article
SN - 1475-2840
VL - 2022
SP - 164
EP - 173
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
ER -