Diabetes: Technologies Make Management Easier
If you have diabetes, you are not alone. An estimated 23.6 million Americans have either type 1 (insulin-dependent) or type 2 (non-insulin dependent) diabetes. And the numbers continue to climb. 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, new technologies offer more 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. Now, advanced systems, called continuous glucose monitors (or CGM), 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, newer products 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. Products now allow you to 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’re 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.
New Developments
Researchers are constantly working on new treatments, some of which have already been used successfully by people with diabetes throughout the world. These include inhaled, transdermal (skin patch), and oral replacements for those ever present needles, and alternative medications to enhance the release of insulin from the pancreas, manipulate certain hormones to balance glucose levels, and prevent complications of diabetes.
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, new technologies have brought the management diabetes 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/
US Food and Drug Administration
http://www.fda.gov/
CANADIAN RESOURCES:
Canadian Diabetes Association
http://www.diabetes.ca/
Team Diabetes Canada
Canadian Diabetes Association
http://www.diabetes.ca/
References:
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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/thisTopic.php?marketID=15topicID=81 . Updated November 2008. Accessed May 26, 2008.
Last reviewed May 2009 by Richard Glickman-Simon, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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