People with type I and certain type II diabetes need blood glucose checks and insulin injections daily to help keep their blood glucose levels within their goal range. Diabetes management has seen a significant transition in recent years as a result of technological advancements.
Diabetes technology comes in various forms, such as insulin pumps and continuous glucose monitoring (CGM). When your doctor mentions diabetes technology, they are likely referring to technology that helps you take insulin or technology that checks your blood sugar levels. CGM has replaced finger pricks, and insulin pumps have made insulin delivery more convenient.
You can decide to adopt diabetes technology and consider whether it is the best option for you. You can discuss it with your healthcare provider.
Thousands of research studies are investigating various sorts of diabetes technology and the benefits it can provide to people with diabetes. These are currently undergoing study and clinical testing at various levels. Some of these have the potential to change the way you manage diabetes in the future.
Continuous glucose monitoring (CGM)
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.
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:
- A combination glucose sensor/transmitter (implanted into your upper arm)
- 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:
- 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.
- 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.
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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.
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New Technologies in Diabetes Care and Management: https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/new-technologies-in-diabetes-care-and-management#:~:text=NIDDK%2Dfunded%20researchers%20are%20developing,and%20destroys%20the%20beta%20cells.
What’s New in Diabetes Technology? https://www.webmd.com/diabetes/features/next-generation-diabetes-technology
Better blood glucose meters and more: https://www.diabetes.org/tools-support/devices-technology