Glucose monitoring is a way of testing the concentration of glucose in the blood. Glucose monitoring is important for diabetes management.
The current technology for monitoring glucose levels has been well established since the 1980s. The practice is helpful l to patients with diabetes from both clinical and economic viewpoints.
The landscape of glucose monitoring technologies is expanding and rapidly changing. A few technological devices leading to improvements in glucose monitoring are discussed.
CGM (Continuous Glucose Monitoring) automatically tracks blood glucose levels throughout the day and night. One can see his blood glucose level at a glance at any time. Further, one can also examine how blood glucose level varies over a few hours (or a few days) to assess and evaluate the trend.
Observing glucose levels in real-time can make one more informed and as such help decides how to balance food/ physical activity/ medicine throughout the day.
A CGM works through a tiny sensor inserted under the skin (usually on the belly or arm).
The sensor measures one’s interstitial glucose level (it is the glucose level found in the fluids between the cells, usually in the interstitial space. As such, glucose measured in interstitial fluids may differ from blood glucose). The sensor tests glucose levels every few minutes. A transmitter wirelessly sends the information to a monitor. Some CGM sends information directly to smartphones.
CGM always keeps on recording glucose levels (whether one is sleeping/ showering/ working/ taking exercise). CGM has many special features that are listed below.
It is also known as .artificial pancreas. The technology links CGM with automatically controlled insulin delivery (it refers to different ways to inject insulin into the body. Different methods of insulin delivery include Syringes/ pens/ pumps /jet injectors. The jet injector is a needle-free device that drives liquid medication to intramuscular and subcutaneous tissues).
CGM is one part of the artificial pancreas system.
The NIDDK (National Institute of Diabetes and Digestive and Kidney diseases) has played an important role in developing artificial pancreas technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots. The artificial pancreas monitors blood glucose levels round the clock and provides insulin and a second hormone glucagon automatically (Glucagon is given by a shot and is used to treat severe low blood sugar called hypoglycemia by raising blood glucose levels). The system can also be monitored remotely.
In 2016, the US FDA (Food and Drug Administration) approved a type of artificial pancreas system called the Hybrid Closed Loop System. The system tests the glucose level every 5 minutes throughout the day and night through a CGM and automatically provides the right amount of basal insulin (basal insulin helps regulate blood sugar levels in people diagnosed with diabetes. It keeps the glucose level steady) through a separate insulin pump.
Conclusively, the Hybrid Closed Loop System may keep the patient free from regular botherations (such as to keep the blood glucose level stable or to help the patient sleep throughout the night without the need to wake the patient in order to test glucose or take medicine). Still, it is wise to talk to the doctor as to whether the system is appropriate for the patient.
Recently, increasing connectivity between glucose monitoring technologies and mobile devices has facilitated ongoing improvements in self-care as well as communication of data.
It is evident that the isolated use of glucose monitoring technologies without a plan for using data provides minimal benefits (particularly among the patients with type-2 diabetes, or who are not using insulin)
In order that glucose monitoring provides the maximum benefits, patients and healthcare providers must be able to easily obtain and communicate the data, and further, data must be organized in such a way that patterns can be identified and the patient can get the feedback at the time of care.
The widespread use of mobile devices provides opportunities for data collection/ analysis/ communication of the results to healthcare providers.
Conclusively, hurdles to wider implementation of mobile technology include lack of usability, lack of safety, and lack of cost-effectiveness.
Some laboratory tests are there which can measure average blood glucose levels over a period of time. They are called ‘ Alternative Markers for Glucose Control‘. These are special markers in the body (that reflect blood glucose levels anywhere from a few weeks to a few months) giving insights into short and long-term blood glucose control. Hemoglobin A1C is one of the best markers to indirectly monitor blood glucose levels. A1C tracks the level of blood glucose over a period of 3 months (A1C is a common blood test used to diagnose type-1 and type-2 diabetes. It monitors how well the patient is managing blood glucose level).
Many new technologies are emerging and increasingly being developed and applied to fight diabetes and its complications. New technologies are expected to improve the quality of life of people with diabetes by measuring glucose and other biomarkers (it is also known as a biological marker. It is a measurable indicator of some biological state or condition. Biomarker is commonly used in basic and clinical research) of glycemic control and linking glucose level with insulin delivery. In this connection, the NIDDK (National Institute of Diabetes and Digestive and Kidney Diseases) continues to explore and examine several important studies on different types of artificial pancreas devices (in the wake of technological improvements) in order to better help patients in the management of type-1 diabetes. This is also expected to help patients with type-2 and gestational diabetes.
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