The place of glucometers in real clinical practice

A. V. Vitebskaya; S. A. Toboleva

doi:10.21518/ms2025-374

The place of glucometers in real clinical practice

A. V. Vitebskaya, S. A. Toboleva

https://doi.org/10.21518/ms2025-374

Full Text:

PDF (Rus)

Generate QR code

Abstract

Introduction. Despite the active use of continuous glucose monitoring (CGM), including flash monitoring (FM), by patients with type 1 diabetes mellitus (T1DM), the use of a glucometer is still actual. According to current clinical guidelines, blood glucose measurements with a glucometer should be performed at least 4 times a day when using CGM and at least 2 times a day when using FM.

Aim. To study the usage of glucometers simultaneously with CGM in children and adolescents with type 1 diabetes in real clinical practice.

Materials and methods. In 12.2024–07.2025, 100 patients (43 girls, 57 boys) 13.0 (9.0; 15.0) years with type T1DM for 4.5 (3.0; 6.6) years and glycated hemoglobin (HbA1c) level 7.0% (6.2; 8.1) answered a questionnaire about the usage of CGM and glucometers. The results were compared with a similar survey in 2016 and 2020–2021.

Results. All patients use CGM and glucometers. Inconsistent use of CGM (17% of patients) and measuring glucose with a glucometer less than once a day (10%) were associated with non-target HbA1c levels – OR 2.068 (95% CI 0.700–6.116) and 2.550 (95% CI 0.620–10.492), respectively.

We detected an increase in the percentage of patients with the target HbA1c level (50%) compared to 2016 (26%; p = 0.019) and 2020-2021 (27%; p < 0.001).

Patients recheck with a glucometer their glucose level measured by the CGM more often (p < 0.001) at high and low values, when changing the sensor, during ARVI and when the values do not correspond to their well-being; the percentage of those who do not recheck the CGM readings decreased from 14% to 2% (p = 0.003).

Conclusion. Comparison of the 2016, 2020–2021 and 2025 survey results demonstrated a significant increase in the percentage of patients achieving self-monitoring goals; the role of every-day use of CGM in combination with daily glucose testing with a glucometer.

Keywords

survey, questionnaire, diabetes, children, glucometers

About the Authors

A. V. Vitebskaya

Sechenov First Moscow State Medical University (Sechenov University)
Россия

Alisa V. Vitebskaya, Cand. Sci. (Med.), Associate Professor of Department of Childhood Diseases, Filatov Clinical Institute of Child Health

19, Bolshaya Pirogovskaya St., Moscow, 119435

S. A. Toboleva

Sechenov First Moscow State Medical University (Sechenov University)
Россия

Sofia A. Toboleva, Student of Filatov Clinical Institute of Child Health

19, Bolshaya Pirogovskaya St., Moscow, 119435

References

1. Laptev DN. Type 1 diabetes in children: adulthood ahead. Diabetes Mellitus. 2025;28(1):18–25. (In Russ.) https://doi.org/10.14341/DM13252.

2. Dovc K, Lanzinger S, Cardona-Hernandez R, Tauschmann M, Marigliano M, Cherubini V et al. Association of Achieving Time in Range Clinical Targets With Treatment Modality Among Youths With Type 1 Diabetes. JAMA Netw Open. 2023;6(2):e230077. https://doi.org/10.1001/jamanetworkopen.2023.0077.

3. Rimskaya AM, Krasnovidova AE, Vitebskaya AV. Practicalities of Flashmonitoring systems utilization in the questionnaire survey of children and adolescents with type 1 diabetes mellitus. Diabetes Mellitus. 2023;26(1):39–48. (In Russ.) https://doi.org/10.14341/DM12889.

4. Vitebskaya AV. Advantages of the new glucose meter in pediatric practice. Meditsinskiy Sovet. 2016;(7):124–127. (In Russ.) https://doi.org/10.21518/2079-701X-2016-07-124-127.

5. Vitebskaya AV, Krasnovidova AE, Rimskaya AM. Factors affecting the choice and usage of glucometers in children and adolescents with type 1 diabetes mellitus. Meditsinskiy Sovet. 2022;(12):64–70. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-12-64-70.

6. Elbalshy M, Haszard J, Smith H, Kuroko S, Galland B, Oliver N et al. Effect of divergent continuous glucose monitoring technologies on glycaemic control in type 1 diabetes mellitus: A systematic review and meta-analysis of randomised controlled trials. Diabet Med. 2022;39(8):e14854. https://doi.org/10.1111/dme.14854.

7. Zhou Y, Sardana D, Kuroko S, Haszard JJ, de Block MI, Weng J et al. Comparing the glycaemic outcomes between real-time continuous glucose monitoring (rt-CGM) and intermittently scanned continuous glucose monitoring (isCGM) among adults and children with type 1 diabetes: A systematic review and meta-analysis of randomized controlled trials. Diabet Med. 2024;41(3):e15280. https://doi.org/10.1111/dme.15280.

8. Maiorino MI, Signoriello S, Maio A, Chiodini P, Bellastella G, Scappaticcio L et al. Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled Trials. Diabetes Care. 2020;43(5):1146–1156. https://doi.org/10.2337/dc19-1459.

9. Tauschmann M, Hermann JM, Freiberg C, Papsch M, Thon A, Heidtmann B et al. Reduction in Diabetic Ketoacidosis and Severe Hypoglycemia in Pediatric Type 1 Diabetes During the First Year of Continuous Glucose Monitoring: A Multicenter Analysis of 3,553 Subjects From the DPV Registry. Diabetes Care. 2020;43(3):e40–e42. https://doi.org/https://doi.org/10.2337/dc19-1358.

10. Cardona-Hernandez R, Schwandt A, Alkandari H, Bratke H, Chobot A, Coles N et al. Glycemic Outcome Associated With Insulin Pump and Glucose Sensor Use in Children and Adolescents With Type 1 Diabetes. Data From the International Pediatric Registry SWEET. Diabetes Care. 2021;44(5):1176–1184. https://doi.org/10.2337/dc20-1674.

11. Laptev DN, Bezlepkina OB, Demina ES, Malievskiy OA, Nikitina IL, Samoilova IG, Peterkova VA. Evaluation of FreeStyle Libre in pediatric t1dm: improved glycemic control, reduction in diabetic ketoacidosis and severe hypoglycemia. Problemy Endokrinologii. 2022;68(3):86–92. (In Russ.) https://doi.org/10.14341/probl12877.

12. Dedov II, Shestakova MV, Galstyan GR, Grigoryan OR, Esayan RM, Kalashnikov VYu et al. Standards of specialized diabetes care. (7th edition). Diabetes Mellitus. 2015;18(1S):1–112. (In Russ.) https://doi.org/10.14341/DM7078.

13. Dedov II, Shestakova MV, Mayorov AY, Vikulova OK, Galstyan GR, Kuraeva TL et al. Standards of specialized diabetes care. 8th edition. Diabetes Mellitus. 2017;20(1S):1–121. (In Russ.) https://doi.org/10.14341/DM20171S8.

14. Dedov II, Shestakova MV, Mayorov AY, Vikulova OK, Galstyan GR, Kuraeva TL et al. Standards of specialized diabetes care. 9th edition. Diabetes Mellitus. 2019;22(1S1):1–144. (In Russ.) https://doi.org/10.14341/DM221S1/.

15. Dedov II, Shestakova MV, Mayorov AY, Mokrysheva NG, Vikulova OK, Galstyan GR et al. Standards of specialized diabetes care. 10th edition. Diabetes Mellitus. 2021;24(1S):1–148. (In Russ.) https://doi.org/10.14341/DM12802.

16. Dedov II, Shestakova MV, Mayorov AY, Mokrysheva NG, Andreeva EN, Bezlepkina OB et al. Standards of Specialized Diabetes Care 11th Edition. Diabetes Mellitus. 2023;26(2S):1–157. (In Russ.) https://doi.org/10.14341/DM13042.

17. Дедов ИИ, Шестакова МВ, Сухарева ОЮ (ред.). Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 12-й выпуск. М.; 2025.

18. DiMeglio LA, Acerini CL, Codner E, Craig ME, Hofer SE, Pillay K, Maahs DM. ISPAD Clinical Practice Consensus Guidelines 2018: Glycemic control targets and glucose monitoring for children, adolescents, and young adults with diabetes. Pediatr Diabetes. 2018;19(Suppl. 27):105–114. https://doi.org/10.1111/pedi.12737.

19. ДDedov II, Shestakova MV, Mayorov AY, Vikulova OK, Galstyan GR, Kuraeva TL et al. Standards of specialized diabetes care. 9th edition. Diabetes Mellitus. 2019;22(1S1):1–144. (In Russ.) https://doi.org/10.14341/DM221S1/.

20. Miller KM, Hermann J, Foster N, Hofer SE, Rickels MR, Danne T et al. Longitudinal Changes in Continuous Glucose Monitoring Use Among Individuals With Type 1 Diabetes: International Comparison in the German and Austrian DPV and U.S. T1D Exchange Registries. Diabetes Care. 2020;43(1):e1–e2. https://doi.org/10.2337/dc19-1214.

21. Dedov II, Shestakova MV, Mayorov AY, Mokrysheva NG, Andreeva EN, Bezlepkina OB et al. Standards of Specialized Diabetes Care 11th Edition. Diabetes Mellitus. 2023;26(2S):1–157. (In Russ.) https://doi.org/10.14341/DM13042.

22. Петеркова ВА, Безлепкина ОБ, Лаптев ДН, Кураева ТЛ, Еремина ИА, Титович ЕВ и др. Клинические рекомендации Сахарный диабет 1 типа у детей. 2025 г. Режим доступа: https://algom.ru/post/nkr00287-Saharnii_ diabet_1_tipa_u_detei__2025_g__(odobreno_NPS_MZ_RF).

23. Eichenlaub M, Pleus S, Rothenbühler M, Bailey TS, Bally L, Brazg R et al. Comparator Data Characteristics and Testing Procedures for the Clinical Performance Evaluation of Continuous Glucose Monitoring Systems. Diabetes Technol Ther. 2024;26(4):263–275. https://doi.org/10.1089/dia.2023.0465.

24. Pleus S, Eichenlaub M, Eriksson Boija E, Fokkert M, Hinzmann R, Jendle J et al. The Need for Standardization of Continuous Glucose Monitoring Performance Evaluation: An Opinion by the International Federation of Clinical Chemistry and Laboratory Medicine Working Group on Continuous Glucose Monitoring. J Diabetes Sci Technol. 2024;14:19322968241296097. https://doi.org/10.1177/19322968241296097.

Review

For citations:

Vitebskaya AV, Toboleva SA. The place of glucometers in real clinical practice. Meditsinskiy sovet = Medical Council. 2025;(19):100–107. (In Russ.) https://doi.org/10.21518/ms2025-374

JATS XML