Diabetes technology: The latest and greatestFriday, 6 April 2018
For World Health Day, we take a look at some of the innovations in diabetes technology that have made managing diabetes easier than ever before.
Continuous Glucose Monitoring (CGM)
CGM tests blood glucose levels continuously throughout the day and night, providing a more thorough picture of blood glucose trends, and it has alarms that can sound when blood glucose levels are high or low. Since first being introduced, CGM technology has advanced. One currently available CGM, the Dexcom G5 Mobile, can transmit data to a smart phone, displaying glucose results and trends while also allowing others, like a parent or carer, to access results. The MiniMed 640g insulin pump uses CGM technology and is able to suspend insulin delivery when a low is predicted via the CGM, helping to prevent hypoglycaemia before it occurs.
Most commonly, CGM is used in combination with insulin pumps. It may help people achieve improved diabetes control and prevent hypoglycaemia. But it’s important to remember that CGM is not for everybody. Speak to your diabetes team to understand whether you’re a good candidate for CGM.
CGM is currently subsidised through the NDSS for people under 21 living with type 1 diabetes, who meet specific criteria (more information on eligibility here). Diabetes Australia does not believe eligibility for subsidised CGM technology should be based on age, and is lobbying for broader access.
Blood Glucose Monitoring
Blood glucose monitoring has moved beyond the early days of home blood glucose meters, which were quite complex and required multiple steps for a fairly inaccurate reading. Today, there are many blood glucose meters available which provide improved accuracy and have a range of bells and whistles. Some of the newer meters are able to send results via Bluetooth to your smart phone or insulin pump. Smart meters are also available that calculate and recommend an insulin dose based on your carbohydrate intake.
The Freestyle Libre meter doesn’t use blood to give you a glucose reading. Instead, it uses interstitial fluid and flash glucose monitoring technology to obtain readings. A reader is swiped across a sensor placed on the back of your arm and then displays glucose results with an arrow indicating the direction your glucose levels are going. This reduces the need for finger prick testing. If you’re interested in some of the newer meters available, speak to your diabetes team to understand which ones may suit you.
Diabetes Australia is currently lobbying the Federal Government to subsidise Abbott’s FreeStyle Libre Flash Glucose Monitoring System under the NDSS. Both the UK and the US government have included the cost of Freestyle Libre under their health systems this year, and we hope Australia isn’t far behind.
In 2017 the ‘artificial pancreas’, which combines an insulin pump and a glucose monitor to automatically deliver insulin when blood glucose levels rise, was made available in the US. The device, created by Medtronic, still isn’t fully automated – users still need to input their carbohydrate count and check their blood glucose levels several times a day. Nevertheless, the MiniMed 670G is a real break-through in diabetes technology and a big step away from finger-prick tests and self-administered insulin injections.
According to the UK National Institute of Health Research, the MiniMed 670G may appear in European markets towards the end of 2018. The device is not available in Australia, but human trials of devices using a closed loop algorithm to autonomously adjust insulin delivery as blood glucose levels rise and fall. are being conducted by the University of Melbourne and St Vincent’s Hospital.
Several companies are developing devices using closed loop algorithms deliver insulin and it is hoped that fully automated device is not too far away.
Thanks to the smart phone, we now have health and lifestyle apps at our fingertips. There are apps available to help you manage blood glucose levels, lose weight, increase physical activity and improve lifestyle. Blood glucose management apps, like mySugr, MyDiabetes (ICM) and Glucose Buddy can help you track and record your blood glucose readings, track medication and understand your glucose trends.
There are a variety of lifestyle apps available and it’s important to seek out reputable quality apps that promote evidence based diet and lifestyle changes. Avoid apps that promote fad diets or quick fixes. Do your research, determine if it’s an app that is easy for you to use and that will help you achieve your goals
As technology continues to advance, new breakthroughs in diabetes management are sure to follow. Remember always speak to your diabetes team before making any changes to your diabetes management.