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Diabetes is a chronic disease that affects millions of people around the world. To avoid complications and maintain quality of life, blood glucose levels must be carefully managed. People with diabetes have relied on self-monitoring blood glucose (SMBG) devices for decades, which require finger pricks and test strips to measure their glucose levels at specific times of the day. However, SMBG has several limitations, such as accuracy, reliability, convenience, and cost. Furthermore, SMBG does not provide an accurate picture of glucose fluctuations during the day and night, which can influence treatment decisions and outcomes.
Fortunately, in recent years, technology has advanced significantly to provide a better alternative: continuous glucose monitoring (CGM). CGM devices work by inserting a small sensor under the skin and measuring glucose levels in the interstitial fluid every few minutes. The sensor wirelessly transmits data to a receiver or a smartphone app, which displays real-time glucose readings, trends, and alerts. CGM devices can also be linked to insulin pumps or artificial pancreas systems, which adjust insulin delivery automatically based on glucose levels.
CGM has many advantages over SMBG for people with diabetes. CGM is capable of:
Detect underlying metabolic disturbances that SMBG would normally miss, such as nocturnal hypoglycemia or postprandial hyperglycemia.
Measure the frequency, duration, magnitude, and distribution of glucose exposure, as well as its variability and stability under daily living conditions.
Give feedback on how food, exercise, medication, stress, and other factors affect glucose levels.
Increase the precision and personalization of therapies based on individual glucose patterns and needs.
Improve your glycemic control and lower your risk of complications.
Improve patient empowerment, satisfaction, and overall quality of life.
Several studies have found that using a continuous glucose monitor (CGM) improves HbA1c levels (a measure of long-term glycemic control), reduces hypoglycemia episodes (low blood sugar), increases time in range (the optimal range of glucose levels), and improves patient-reported outcomes. CGM is especially useful for people with type 1 diabetes who require intensive insulin therapy, but it can also help people with type 2 diabetes who are taking multiple daily injections or oral medications.
CGM technology is rapidly evolving and becoming more accessible and affordable to diabetics. Among the most recent innovations are:
Tandem Mobi: A hybrid mini-pump that can be controlled remotely using a smartphone app (insulin dosing) 5 Omnipod 5: A tubeless patch pump that works with the Dexcom G6 CGM to deliver insulin automatically. 5 Medtronic 780G: An advanced hybrid closed loop system that delivers insulin and glucagon-like peptide-1 (GLP-1) analogues using the Guardian 3 CGM. 5 Eversense XL: A long-term implantable CGM sensor that provides continuous data and alerts via a transmitter and an app for up to 180 days. 5 Abbott FreeStyle Libre 3: A 14-day sensor that is smaller, thinner, and more accurate than its predecessor. 5
These new diabetes management devices promise to make diabetes management easier, more convenient, and more effective for diabetics.
If you have diabetes or are at risk of developing it, you should think about using CGM to track your glucose levels. Discuss the benefits and risks of CGM with your doctor to determine if it is right for you. You should also confirm your insurance coverage and eligibility for CGM reimbursement.
CGM is not intended to replace SMBG, but rather to supplement it by providing additional information and insights into your glucose control. Before taking action, you should still perform SMBG to calibrate some CGM devices or confirm high or low readings.
CGM is not a panacea that will solve all of your diabetes issues. You must still maintain a healthy lifestyle, take your medications as directed, and consult with your healthcare team on a regular basis. CGM, on the other hand, can assist you in achieving better glycemic control and improving your quality of life.
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Sources:
- https://www.sciencedirect.com/science/article/pii/S1751991820301649
- https://www.healthline.com/diabetesmine/new-diabetes-technology-in-2022
- https://www.diabetesselfmanagement.com/blog/history-future-blood-glucose-monitoring/
- https://www.medtechintelligence.com/feature_article/innovations-in-self-monitoring-blood-glucose-devices-will-impact-healthcare-services/
- https://pubmed.ncbi.nlm.nih.gov/32273189/
