Glycaemia Beyond Hba1c: Understanding the Limitations of Hba1c and Rationalising the Use of Continuous Glucose Monitoring to Optimise Glycaemia in Type 2 Diabetes

Diabetes prevalence in Singapore is rising, with a large percentage of people with diabetes not achieving target haemoglobin A1c (HbA1c) levels.Monitoring of glucose levels is an integral part of diabetes management.Traditional methods like HbA1c and self-monitoring of blood glucose (SMBG) have limitations, especially in people with high glucose variability.Continuous glucose monitoring (CGM) technology has advanced considerably in the past few decades and provides real-time insights on glucose levels (overcoming the limitations of HbA1c), without the need for frequent finger pricking required for SMBG.CGM-derived metrics like time in range provide a comprehensive view of glycaemia, aiding in personalised management plans and reducing diabetes complications.CGM shows promise not only for type 1 diabetes, but also for type 2 diabetes management, improving HbA1c levels, reducing hypoglycaemia, and enhancing lifestyle modifications.In this review, the role of CGM in type 2 diabetes care is summarised.