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[IP] Re: AACE 2011 Guidelines

I received the following reply from an endocrinologist who was a contributor
to the American Association of Clinical Endocrinologists (AACE) 2011
Dear Mr. Smith:
Lori forwarded your message to me. First of all, I gratefully acknowledge your
interest in the new AACE diabetes guidelines. I understand your feeling only
too well, having quite a few patients in my private practice using their CGM
successfully for many years. The issue at hand is that guidelines issued by
any society are quite different from state of the art reviews etc. As you can
see from the methodology employed in the AACE (and any other) guidelines they,
by definition, are evidence driven. What that means is that there have to be
randomized prospective trials on the subject before clear-cut recommendations
for practitioners can be made. For continuous glucose monitoring these are
only now beginning to appear (see, for example, the trial reported in the
April 2011 issue of Diabetes Care). I have no doubt that once sufficient
peer-reviewed evidence of benefits of continuous glucose sensors appear, AACE
will strengthen the recommendations. In the
 meantime,  please see the AACE position statement on continuous glucose
monitoring (not guidelines) which we published last Fall in Endocrine
Practice. Thank you once more for your kind consideration.

Any comments?
Jerry Smith
Rochester, NY
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