The Ups and Downs of New Continuous Glucose Monitoring|
By Amy Tenderich of www.DiabetesMine.com
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There is a world of gadgets associated with diabetes care. Some of them are essential, and others are personal choices, depending on how much you like gadgets and whether you're the type of patient who wants to be on the cutting edge of aggressive new treatments.
One very new area of technology is continuous glucose monitoring (CGM), introduced to the market in mid-2006 and creating a lot of buzz at the moment. Rather than providing a one-time "snapshot" of your blood glucose (BG) at a single point in time as today's conventional glucose meters do new continuous monitors deliver nonstop readings every few minutes around the clock, so you can watch the whole "movie."
The devices on the fast track to patients now are "subcutaneous," meaning they're inserted under the skin via a tiny flexible probe, which is connected to a controller unit either via a small plastic tube, or wirelessly, using infrared technology. They measure your BG levels in the interstitial fluid (the fluid surrounding body cells) every 5 minutes and store the readings. A screen lets you view your current reading, and also uses dots or arrows to show whether you're headed up or down. The data can also be downloaded to a computer later to produce detailed charts of your glucose levels throughout the day.
So why would you want to wear a "real-time" monitor attached to your body?
There are some major advantages. First, CGM provides insights into BG trends, so you and your doctor can chart your ups and downs on a running basis, identify problems and make corrections in your regime. You might notice, for example, that you are consistently peaking after breakfast or overnight perhaps times when you were less likely to check your BG using a fingerstick test. No such comprehensive view of BG activity has ever been available to people with diabetes before!
Second, CGM provides a safeguard that today's monitors can't match. Alarms alert you to hypoglycemia (dangerously low blood glucose levels) or hyperglycemia (dangerously high blood glucose levels) the moment they hit.
Finally, living well with diabetes is all about improving glucose control. Studies show that using a continuous monitor can make an enormous difference for both Type 1 and Type 2 patients crucial for avoiding long-term diabetes complications.
Continuous monitors are still in the early stages, meaning that accuracy is still being studied. The models available now (from MiniMed and Dexcom) actually require several daily calibrations with your regular fingerstick glucose meter for precision. In part for this reason, they are still quite pricey and not yet covered by most insurance plans.
The other key issue is what to do with all that data? Some experts believe the detailed charts produced by CGM systems are much more than patients either need or can interpret on their own. Meanwhile, doctors are already hard pressed for time, and there is no incentive as yet for them to pour over patient's CGM data; health plans are not currently paying for this.
In other words, while continuous glucose monitors do have the potential to revolutionize diabetes care, it's not time to send your traditional meter off to the scrapheap yet.
As a number of companies race to develop high-accuracy CGM systems including Abbott and LifeScan the medical community debates: Who really needs these systems? In fact, adults with both Type 1 and Type 2 diabetes can discover how diet, exercise, medication and other factors affect their BG and how fast. Studies are showing that CGM can also be safe and very effective for children.
Even if all the players were to agree that CGM and all the information it produces were critical for every diabetes patient, one critical question would remain: how exactly will patients and doctors share and utilize the data? Well, a number of companies are working on new products that will transmit the BG results to your doctor, nurse or educator via wireless computer technology including GlucoTel, GlucoMON, and Virtual Tracker, to name a few.
So the diabetes gadget parade marches on. It brings the promise of significantly improving our health, but with a few technical ups and downs along the way.
Amy Tenderich hosts the popular web log www.diabetesmine.com and is co-author of the new book, "Know Your Numbers, Outlive Your Diabetes," the first-ever hands-on guide to achieving a long and healthy life with diabetes. Find out how to get your free copy today.