What Is the New Technology for Diabetes?

CGM, commonly known as blood sugar monitoring, automatically tracks blood glucose levels throughout the day and night through a button-like device that is fixed to a person’s arms.

• You may view your glucose level at a glance at any moment.
• You may look at how your glucose levels fluctuate over a few hours or days to determine if there are any diet or activity changes.
• Seeing your glucose levels in real-time can help you make more educated decisions about how to balance your meals, physical activity, and medications throughout the day.

CGM works by inserting a small sensor (almost painless cannula) beneath your skin, commonly on your abdomen or arm. The sensor detects interstitial glucose, which is glucose contained in the fluid between cells. Every few minutes, the sensor checks the glucose level. Data are wirelessly sent to a monitor by a transmitter.

CGM devices have evolved throughout time, with significant advancements in accuracy, dependability, and simplicity of use. However, there are several key distinctions between the two primary types of CGM—real-time and intermittently scanned—that you should consider when selecting the proper system for you.

Real-time CGM

The sensor (a thin wire catheter implanted under the skin on your arm or belly), a transmitter that links to the sensor, and a portable receiver and/or smartphone that shows your glucose readings in real-time are the three components of a real-time CGM device.

Advantages of real-time CGM include:

• It often alerts you when the blood sugar levels spike. 
• Data about your glucose levels are recorded and continuously sent to the app installed on your phone.
• It shares the data with your close associates and alerts them about fluctuations in your blood sugar levels so that they will be able to help you.
• It eliminates the need for finger pricks to test for blood glucose levels.

Disadvantages of real-time CGM include:

• You need to work on setting up the alert features, which are quite complicated and necessitate you to spend some extra time on the initial setup.
• Repeated alerts may be disturbing at times.
• It is not pocket-friendly.

Intermittently scanned CGM

To obtain glucose data from this system, you must scan the device, which consists of two parts:

1. A combination glucose sensor/transmitter (implanted into your upper arm)
2. A separate touchscreen reading device

Depending on the model, the sensor continually collects and monitors glucose readings, creates a new glucose value every minute, and records the data every 15 minutes for 10 to 14 days of sensor wear time.

Advantages of intermittently scanned CGM include:

• The sensor is small, painless to apply, and comfortable to wear. The transmitter can be scanned through clothes, so it is beneficial if you want it to be discreet.
• It is less expensive than real-time CGM, and the cost is covered by most insurance companies.
• Data regarding your blood glucose levels can be shared with up to 20 members who are using smartphones.
• It eliminates the need for finger-prick tests.

Disadvantages of intermittently scanned CGM include:

• It doesn’t offer any alerts when there are any serious changes in blood glucose levels.
• You need to wave the reader over the transmitter for glucose values. Older information will be overwritten, and if not collected, the info is lost.
• If a new sensor is placed, information about blood glucose levels will not be noted for the first 12 hours. If you need to know blood glucose values, a finger prick test is to be done.

An insulin pump delivers continuous short-acting insulin throughout the day. Moreover, it eliminates the need for many daily injections in favor of a continuous insulin infusion, which helps improve blood sugar levels.

• An insulin pump is a small device that is placed in the suitable location of the body of the receiver and mimics the action of the pancreas in the body.
• The insulin pump is set up to fit the demands of the person wearing it.
• Insulin is injected into the fatty tissue through a short plastic tube known as a cannula that is connected to a reservoir in the pump.
• A needle, known as an infusion set, is used to implant the cannula under the skin. To avoid infection, it is replaced every two to three days.
• In a pump, only insulin with a short half-life is used. There is no need for long-acting insulin because the pump continually administers insulin.

An insulin pump enhances diabetes management and reduces the risk of hypoglycemia. When using an insulin pump, many people find that they have more freedom in the timing of their meals and activities. Individuals who get several daily insulin injections and have their blood glucose levels checked several times each day are motivated to use insulin pumps.

Two types of insulin pumps include:

1. Traditional insulin pumps: Traditional insulin pumps include an insulin reservoir or a container, a pumping machine, tubing, and an infusion set that connects to the body. The pump body features buttons that allow you to schedule insulin administration for meals, particular types of basal rates and, if required, interrupt insulin infusion.
2. Insulin patch pumps: These are small patches worn directly on the body, and they contain all the components such as a reservoir, a pumping machine, and an infusion set within a compact container. This permits regulation of insulin administration for meals from the patch controls patch pumps remotely.

Many pumps wirelessly connect to blood glucose meters, which use a drop of blood from your fingertip to assess blood sugar levels. Some pumps communicate wirelessly with CGM devices, which are placed beneath the skin and continuously monitor blood sugar levels throughout the day.

Other forms of technology, such as ketone monitors that assess the level of ketones in the blood, can help you manage your diabetes. Ketones are harmful compounds that can form in the body if there isn't enough insulin to enable adequate glucose into the cells.

High ketone levels in the blood can cause diabetic ketoacidosis, a potentially fatal illness. Ketone monitors are advised for all people with type I diabetes. If you use insulin and have another type of diabetes, you may benefit from ketone monitors.

Closed-loop insulin administration (artificial pancreas) is a relatively new medical invention that aims to lessen the danger of hypoglycemia while maintaining tight glucose control. Closed-loop systems incorporate glucose-sensing and insulin-delivery components and are distinguished by real-time glucose-responsive insulin administration. 

• A disposable sensor analyzes interstitial glucose levels, which are supplied into a control algorithm that controls the administration of a rapid-acting insulin analog into the subcutaneous tissue by an insulin pump in the most feasible and studied form. 
• The advancement of research is based on the increased usage of insulin pumps and the availability of glucose monitors.

Smart pens are new-generation insulin delivery devices that have a reusable injector pen with a built-in smartphone app to help people with diabetes manage insulin delivery with more accurate doses and timing. These devices also estimate the insulin quality, including storage conditions and shelf-life. Moreover, they send relevant data to your healthcare provider whenever needed. They can be bought as an add-on to your current insulin pen or in reusable form with prefilled cartridges.

If you were to ask a person with diabetes what they dread most about diabetes management, most of them would agree that it is the repeated pricks needed for glucose monitoring, which can be both painful and inconvenient. A laser blood glucose monitor is one of the most affordable, painless, and convenient devices for tracking blood glucose levels. The device is based on the principle of spectroscopy (how a substance interacts with light) to measure blood glucose levels by the use of laser light on the skin.

People with diabetes are at a higher risk of cardiovascular diseases including heart attack and stroke. According to data from the American Heart Association, about 65% of people with diabetes die from these conditions. The ultrasound patch for cardiovascular risk assessment is a flexible, wearable patch that measures blood pressure and detects heart problems. It uses ultrasound waves to monitor blood pressure by recording the diameter of a pulsating blood vessel, and the collected data is further translated into measurements that detect problems such as high blood pressure, heart disease, and heart valve issues. Research is underway to make this device more convenient and practical for people with diabetes.

Islet chips are novel devices being explored by the National Institute of Diabetes and Digestive and Kidney Diseases to develop newer therapies for the treatment of type I diabetes. Islets are groups of cells in the pancreas that are destroyed by the autoimmune response in people with diabetes. An islet chip is a synthetic model that imitates the way the human body supports islets to allow them to survive and function in the lab.