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Comment & Response
April 3, 2018

Continuous Glucose Monitors for Insulin Dosing

Author Affiliations
  • 1Jaeb Center for Health Research Foundation, Tampa, Florida
JAMA. 2018;319(13):1383. doi:10.1001/jama.2018.0185

To the Editor Dr Shapiro1 raised concerns about using continuous glucose monitors (CGMs) to determine insulin dosing without a confirmatory blood glucose meter measurement, referred to as nonadjunctive CGM use. He suggested that the US Food and Drug Administration (FDA) was remiss in not considering device deficiency reports, which in his view are indicative of the lack of sufficient accuracy of CGMs for insulin-dosing decisions. Shapiro assumed that accuracy of blood glucose meters exceeds that of CGMs. Although this is true for some meters, current-generation CGMs have an accuracy level similar to or better than many blood glucose meters.2 The same concerns he raised for CGMs could be raised for many blood glucose meters.

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