Asia-Pacific Perspectives on the Role of Continuous Glucose Monitoring in Optimizing Diabetes Management.

Diabetes is prevalent, and it imposes a substantial public health burden globally and in the Asia-Pacific (APAC) region. The cornerstone for optimizing diabetes management and treatment outcomes is glucose monitoring, the techniques of which have evolved from self-monitoring of blood glucose (SMBG) to glycated hemoglobin (HbA1c), and to continuous glucose monitoring (CGM). Contextual differences with Western populations and limited regionally generated clinical evidence warrant regional standards of diabetes care, including glucose monitoring in APAC. Hence, the APAC Diabetes Care Advisory Board convened to gather insights into clinician-reported CGM utilization for optimized glucose monitoring and diabetes management in the region. We discuss the findings from a pre-meeting survey and an expert panel meeting regarding glucose monitoring patterns and influencing factors, patient profiles for CGM initiation and continuation, CGM benefits, and CGM optimization challenges and potential solutions in APAC. While CGM is becoming the new standard of care and a useful adjunct to HbA1c and SMBG globally, glucose monitoring type, timing, and frequency should be individualized according to local and patient-specific contexts. The results of this APAC survey guide methods for the formulation of future APAC-specific consensus guidelines for the application of CGM in people living with diabetes.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: ST is a paid member of APAC diabetes care advisory board and the Chair of the Abbott Diabetes Care Australian National Advisory Board for FreeStyle Libre Flash Glucose Monitoring; receives project-specific research funding from Abbott Diabetes Care for clinical studies of FreeStyle Libre Flash Glucose Monitoring; and is an Australian National Board member of the AstraZeneca Advisory Board, the Sanofi-Aventis Australian Advisory Board, and Australian Nevro Advisory Board. SL is a paid international advisory board member for Novo Nordisk, AstraZeneca, and Sanofi; has received honoraria for lectures from Novo Nordisk, Sanofi, Boehringer Ingelheim, AstraZeneca, and MSD; and has received research funding from MSD, Astellas, Daiichi Sankyo, and CKD. S-HY, LC, and YB have no conflicts of interest to declare. AK has received honoraria for consultancy or speakership from Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Kyowa Kirin, Merck Serono, Nestle, Novo Nordisk, Pfizer, and Sanofi. EY is a paid member of the APAC Abbott Advisory Board and has received speaker honoraria from Abbott, Medtronic, Novo Nordisk, and Boehringer Ingelheim. SPC has received honoraria as speaker and as a member of advisory boards from AstraZeneca, Boehringer Ingelheim, Merck, Novo Nordisk, Servier, Sanofi-Aventis, ZP Therapeutics; and is a paid member of APAC Abbott Diabetes Care Advisory Board. JR is a paid member of the APAC Abbott Advisory Board and has received speaker honoraria from Abbott, Sanofi, Novo Nordisk, Eli Lilly, Merck, MSD, Novartis, and Boehringer Ingelheim. VM has received honoraria, speaker support, and research grants from Abbott, MSD, Novo Nordisk, and Lifescan and has received speaker fees from Roche Diabetes Care, Medtronic, USV, Dr. Reddy’s Laboratories, Novo Nordisk, Sanofi-Aventis, and several Indian pharmaceutical companies. NC is a paid member of the Abbott Diabetes Care Australian National Advisory Board for FreeStyle Libre Flash Glucose Monitoring and has received research support from Boehringer Ingelheim, AstraZeneca, Novartis, Sanofi, Novo Nordisk, and Ypsomed. MM is a paid member of the APAC diabetes care advisory board and sits on the Abbott Diabetes Care Australian National Advisory Board for FreeStyle Libre Flash Glucose Monitoring; and receives lecture fees from Abbott Diabetes Care. LJ has received consulting and lecture fees from Eli Lilly, Novo Nordisk, Merck, Bayer, Sanofi-Aventis, Roche, MSD, Medtronic, AstraZeneca, Boehringer Ingelheim, and Abbott.