Is real time glucose monitoring feasible for patients with type 1 diabetes mellitus?

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Previous attempts at real time glucose monitoring have proven difficult because of issues with accuracy, skin irritation, and problems with patient discontinuation of use. Nevertheless, real time glucose monitoring holds great promise for patients to be able to monitor changes in blood glucose and adjust insulin doses accordingly. This methodology could prevent episodes of hypoglycemia with a warning system while helping patients achieve tighter diabetes control. In this issue of The Journal, Buckingham et al report on results from the Diabetes in Children Research Network (DirecNet) Study Group on real time glucose monitoring in a case series of children. Patients averaged 149 hours of use of the monitor per week. The average hemoglobin A1c improved over 13 weeks of use. In general, patients were able to use the monitor with few problems; however, some had a reaction to the adhesive used to keep the sensor in place. The next step will be a randomized clinical trial comparing this methodology with the traditional forms of glucose monitoring.