New Diabetes Control Tools: Continuous Glucose Monitors continued...
There is some debate about the accuracy of CGMs compared to regular blood glucose meters. "Scientists are creating standards to measure the new devices' accuracy," says Klonoff.
But some research already shows encouraging results. The journal Diabetes Care published a study of 91 diabetes patients. Subjects using CGMs spent 26 percent more time in normal glucose range than a control group without the devices.
Does this mean that people can toss out their dreaded lancets? Not yet, says Sabicer. Currently, all CGMs instruct users to do a "confirmatory" finger stick test before taking action, such as injecting insulin. Also, CGMs aren't approved for those under 18, and insurance may not cover the devices.
But Kowalski, who has used a CGM , says that many people -- including him -- are already beginning to free themselves from finger sticks. He's down to 2 finger sticks per day and he does this only to calibrate the device. The rest of the time, he relies on the CGM readings.
"It is life-changing," he says, adding that he believes continuous sensing will soon completely change diabetes.
"Certainly, we're moving toward a finger stick replacement with improving the accuracy of these devices," says Sabicer. But for now, Medtronic urges patients to keep double-checking readings.
Another advantage of continuous monitoring: It alerts a patient when glucose is too high or low. Although some users have complained of being awakened too much, an alarm will sound if glucose levels fall dangerously low during sleep. "It's a great tool that's never been available before," Sabicer says of CGMs. "Patients have a security blanket or insurance policy that's always looking out for them."
New Diabetes Control Tools: Combination Continuous Glucose Monitor and Insulin Pump
Patients who use insulin now have another option besides stand-alone CGMs. Medtronic's MiniMed Paradigm REAL-Time is the first combination CGM and insulin pump.
"Patients can both monitor their blood glucose and administer insulin therapy through the insulin pump."
It's not an automated system; patients must still make decisions about insulin dosing. But the Juvenile Diabetes Research Foundation hailed it as a "significant step" toward one of its major research priorities: That is development of an external, artificial pancreas that could someday automatically measure glucose and deliver insulin -- much like the real thing.
More recently, the FDA approved a new physician-use continuous glucose monitoring (CGM) system. Patients wear the CGMS iPro Recorder for three days, and physicians can review the data.
New Diabetes Control Tools: Diabetes Information Management Software
Increasingly sophisticated software programs allow patients who use regular blood glucose meters to track and analyze trends, Klonoff says. Patients can download stored data from their meters onto a computer through a USB port. Then, for example, they can view charts that show what percentage of time their glucose levels were within normal ranges, as well as above or below normal.