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Continuous Glucose Monitoring (CGM) describes the glucose profile between blood glucose measurements undertaken at specific times and thus represents the perfect symbiosis with conventional blood glucose measurement. In the context of diagnostic investigation, it has resulted in a surprising extension of the picture on the treatment of diabetes. Beyond this context of diagnostic application, the continuous display of the current glucose level makes possible subtle regulation of insulin therapy, especially insulin pump therapy. Several clinical studies have provided significant proof of the advantage of Sensor-Augmented Pump Therapy (SAP). The focus of this book is the new dimension of "glucose dynamics". The discussion begins with the technological bases of CGM and SAP, it encompasses relevant scientific data/studies and extends to the clinical application. Practical examples and the interpretation of glucose curves ensure that the material is relevant to clinical practice. The authors of this book have an extensive wealth of knowledge and experience with CGM and SAP. With this book, they have for the first time compiled a practical monograph on this subject area, one that is not yet present in the literature. The book is a "must" on a highly relevant current and future aspect of diabetology.

Inhaltsangabe1. State of the art in the technical development of modern insulin pumps 10 1.1. Historical development of insulin pumps 10 1.2. Change in the indications for CSII 12 1.3. Characteristics and functionality of modern insulin pumps 13 1.3.1. Currently available insulin pumps 13 1.3.2. The "treasures of insulin pump therapy" 13 1.3.2.1. Overview 13 1.3.2.2. "CSII treasure number 1": multibasal rate administration 16 1.3.2.3. "CSII treasure number 2": different bolus options 17 1.3.2.4. "CSII treasure number 3": bolus calculator 17 1.3.3. Differences in the functions of modern insulin pumps 18 1.3.4. Use of the standard function of modern insulin pumps 19 1.3.5. Association of CSII and CGM for SAP 20 1.3.6. "Patch pumps" - insulin pumps without catheters 21 1.3.7. Implanted insulin pumps 22 1.4. Summary 23 1.5. References 23 2. Technical developments in the field of continuous glucose monitoring 26 2.1. Principles of the detection of glucose in blood or in interstitial fluid 26 2.2. Basic possibilities for continuous glucose monitoring (CGM) 28 2.2.1. Overview 28 2.2.2. Glucose monitoring in interstitial fluid with minimally invasive sensors 29 2.2.3. Glucose monitoring with implantable glucose sensors 30 2.2.4. Glucose monitoring with non-invasive glucose sensors 31 2.3. Properties and comparison of the available systems of the needle sensor type 33 2.4. References 38 3. Characteristics of continuous glucose monitoring (CGM) 42 3.1. Methods of CGM 42 3.1.1. Distinction between diagnostic and therapeutic use 42 3.1.2. Diagnostic application of CGM 42 3.1.3. Use of CGM in everyday treatment control 44 3.2. Differences in CGM in relation to self-monitoring of blood glucose (SMBG) 46 3.2.1. Uninterrupted measurement and visualisation of the dynamic glucose profile as a result of CGM 46 3.2.2. Consequences of CGM measurement in interstitial fluid 46 3.2.3. Calibration of CGM 47 3.2.4. Setting of alarms and pre-alarms 49 3.3. Utilisation of software for the display, analysis and evaluation of CGM measurements 50 3.3.1. Overview 50 3.3.2. Displays in CareLink software 51 3.3.2.1. CareLink PERSONAL 51 3.3.2.2. CareLink PRO 52 3.3.2.3. CareLink iPro 55 3.3.3. Summary 56 3.4. References 56 4. Aspects of the combination of glucose sensor and insulin pump 62 4.1. Potential of the combination of insulin pump and sensor 62 4.2. Support of CGM when starting a patient on insulin pump therapy 62 4.3. Utilisation of CGM profiles for training pump wearers 63 4.4. Influence of CGM on the full exploitation of the extended functions of modern insulin pumps 64 4.5. CGM as proof of successful pump initiation for the medical insurance companies 65 4.6. Sensoraugmented pump therapy (SAP) 66 4.7. Interconnection of glucose sensor and insulin pump for the closed loop system 69 4.8. References 72 5. Problem analysis from glucose profiles recorded with CGM 76 5.1. Overview 76 5.2. The magic of blood glucose and what interstitial glucose tells us about it 76 5.3. Hypoglycaemic episodes 77 5.3.1. Forensics with an evolutionary biological background 77 5.3.2. Classification of hypoglycaemia based on its symptoms 78 5.3.3. Clinical pathology of compromised counter-regulation 79 5.4. Use of CGM for the analysis of the glucose profile and detection of hypoglycaemia 79 5.5. Characteristic details in the CGM profiles 81 5.6. "Criminology" of the glucose level 83 5.6.1. Fine analysis of glucose profiles by "forensic detective work" 83 5.6.2. Criminology of nocturnal hypoglycaemia and its consequences 84 5.6.2.1. Possible motive and opportunity 84 5.6.2.2. From clues to the profile of the offender 84 5.6.2.3. Catching red-handed 85 5.6.2.4. Scene of the crime and search for tracks (standard pattern) 86 5.6.2.5. Disguises and deception 87 5.6.2.6. The usual suspects 89 5.6.2.7. Key points for "criminology" 89 5.6.3. Example of a patient 90 5.7. References 93 6. Getting started on sensor-augmente