• Diabetes: Technologies Make Management Easier

    HCA image for blood sugar testing If you have diabetes, you are not alone. There are many Americans who have either type 1 (insulin-dependent) or type 2 (non-insulin dependent) diabetes. Effective treatment requires vigilant monitoring to keep glucose levels in a healthy range. Chronically elevated glucose in the blood can lead to serious eye, kidney, heart, and nerve disease. Fortunately, there are technologies that offer convenient ways to manage the disease and prevent complications.

    Continuous Glucose Monitor (CGM)

    The standard way of measuring blood glucose involves taking a blood sample from your fingertip and using a meter to check your glucose levels. But there are advanced systems, called continuous glucose monitors (or CGM), that offer more convenience and less pain. With a CGM, you place a tiny sensor under your skin. This sensor, which needs to be replaced every few days, measures glucose levels and sends the information to a wireless device that you wear. You can program the monitor; for example, it can take measurements every five minutes (around the clock) and sound an alarm if your levels become too high or too low.
    Depending on the product, the information stored on the device can be downloaded to your computer. Special software allows you to track your levels and identify trends, providing important data to share with your doctor. Additionally, some devices allow you to press a button to record “events,” like when you give yourself an insulin shot, have a meal, or exercise. This information gets captured, as well, to create a picture of your diabetes management.
    The downside of CGMs is that they may not be as accurate as the standard meters and finger prick samples. If you decide to switch to a CGM, your doctor may have you use both methods to test your glucose before changing your insulin dose.

    Combined Systems: CGM and Insulin Pump

    While insulin pumps have been around for several decades, there are other products that pair the pump with the CGM. This system is comprised of a sensor and glucose monitor, a pump (a small device that contains insulin), and tubing that is inserted under the skin to deliver insulin. The monitor transmits information wirelessly to the pump, which has a calculator to determine how much insulin you should receive. The dose is based on a number of factors, like the time and amount of your last insulin dose, your current blood glucose level, and the amount of carbs that you plan to eat. By combining technologies, these advanced products are designed to help you manage your diabetes by automatically fine-tuning the insulin dose, avoiding calculation errors, and adding convenience.

    Home A1C Test

    The A1C (also called the glycated hemoglobin or HbA1c) test shows the glucose levels in your body over the past 2-3 months. This test is important because it gives you and your doctor an overall view of how well you are managing diabetes and whether you need changes to your treatment plan.
    In the past, you had to visit your doctor to have this test done. Now, you can check your A1C levels at home using a finger prick test with results available within minutes—no waiting in the doctor’s office and no waiting for results to return from the lab.
    The accuracy of these home tests may vary, though. If you are interested in using one, your doctor can recommend a product and teach you how to use it. Remember, too, that you need to share the test results with your doctor so she can make adjustments to your plan as necessary.
    Researchers are constantly working on new treatments, some of which have already been used successfully by people with diabetes throughout the world. Of course, the ultimate solution for people who are insulin-dependent would be to enable the body to make its own insulin again. Better methods for transplanting healthy islet cells (insulin producers of the pancreas) or coaxing stem (embryonic) cells to produce insulin may one day offer a cure for diabetes. Even without a cure, today's products have brought diabetes management a long way since the discovery of insulin in 1921.

    RESOURCES

    American Diabetes Association http://www.diabetes.org/

    National Institute of Diabetes and Digestive and Kidney Diseases http://www.niddk.nih.gov/

    United States Food and Drug Administration http://www.fda.gov/

    CANADIAN RESOURCES

    Canadian Diabetes Association http://www.diabetes.ca/

    Team Diabetes CanadaCanadian Diabetes Association http://www.diabetes.ca/

    References

    A1C. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/a1c/. Accessed July 28, 2011

    Bailey TS, Zisser HC, Garg SK. Reduction in hemoglobin A1C with real-time continuous glucose monitoring: results from a 12-week observational study. Diabetes Technol Ther. 2007;9:203-210.

    Blood glucose: monitoring and data management systems. American Diabetes Association website. Available at: http://www.diabetes.org/uedocuments/df-rg-monitors-0108.pdf. Accessed May 26, 2008.

    Continuous glucose monitors (CGMs). Juvenile Diabetes Research Foundation International website. Available at: http://www.jdrf.org/index.cfm?page%5Fid=106136. Accessed July 28, 2011.

    The facts about continuous glucose monitoring. Joslin Diabetes Center website. Available at: http://www.joslin.org/managing%5Fyour%5Fdiabetes%5F4482.asp. Accessed May 26, 2008.

    FDA clears home glycated hemoglobin test for diabetics. Food and Drug Administration website. Available at: http://www.fda.gov. Accessed June 30, 2003.

    FDA clears new diabetes device for marketing. Food and Drug Administration website. Available at: http://www.fda.gov. Accessed July 8, 2003.

    Garg S, Zisser H, Schwartz S, et al. Improvement in glycemic excursions with a transcutaneous, real-time continuous glucose sensor: a randomized controlled trial. Diabetes Care. 2006;29:44-50.

    Haupt A, Berg B, Paschen P, et al. InDuo, a novel combined insulin injection and blood glucose monitoring device—effective and save as other devices, and patient preference. Exp Clin Endocrinol Diabetes. 2005;113:541-544.

    Insulin pumps. Diabetes.co.uk website. Available at: http://www.diabetes.co.uk/insulin/Insulin-pumps.html. Accessed May 26, 2008.

    Medtronic announces FDA clearance of new OneTouch Ultralink blood glucose meter. Medtronic website. Available at: http://wwwp.medtronic.com/Newsroom/NewsReleaseDetails. Published April 2008. Accessed May 26, 2008.

    Treatments for type 1 diabetes. EBSCO Publishing Health Library website. Available at: http://www.ebscohost.com/healthLibrary/. Updated November 2008. Accessed May 26, 2008.

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