Continuous Glucose Monitoring

1. Continuous Glucose Monitoring Prepared By: Weston Cook

2. What is Glucose Monitoring? Glucose monitoring is a process that helps diabetics manage the disease and avoid its associated complications. The most common way to check glucose levels involves a finger prick with a lancing device to obtain a blood sample, and then the use of a glucose meter to measure the blood sample’s glucose level. Calculations by meters have a 5-10% accuracy and take 5 seconds to nearly a minute.

3. What is Continuous Glucose Monitoring (CGM)? • Continuous Glucose Monitoring systems use a tiny sensor inserted under the skin to check glucose levels in tissue fluid. • The sensor stays in place for several days to a week and then must be replaced. • A transmitter sends information about glucose levels via radio waves from the sensor to a wireless device.

4. How It Works A: Insulin Pump that is set up to receive radio transmissions, from label D, and controls the administration of insulin. B: Insulin Transfusion Set that is attached to the body and remains in use for up to three days before requiring replacement. C: A tiny glucose sensor that is inserted into subcutaneous tissue, also requires replacement after three days of use. D: Small light weight device attached to the glucose sensor and is used to transmit the collected data to a digital read out, in this case the insulin pump.

5. Information Shown By The Display Device A: A current REAL-Time glucose level, similar to a finger stick from traditional methods of glucose monitoring. B: Preset alarms that alert the user by tones or vibration. Alarms are set to alert the user of glucose levels outside the predetermined and set range, either high or low. C: Arrows used to show the direction of the rate of change between glucose level tests to better judge future actions. D: Active graph that shows a curve of where your blood sugar levels have been and how they were effected by stimuli (Meals, Insulin injection, and Exercise).

6. How the Information is Used • Blood Glucose levels are taken ever 10 seconds and averaged together to provide a read out ever 5 minutes. • This amount of readings seems as over kill, but makes the 5 minute readouts quite accurate. • The derivative of the glucose levels are used to show in what direction the glucose levels are trending.

7. Does 250 = 250? • It the mathematical world this is true • 250 does equal 250 • This is also a true statement for diabetics that do not have the technology of continuous glucose monitoring • When viewing a single reading at any point in time, the number is exactly what the meter read out shows. • However, with continuous glucose monitoring 250 can equal 250 increasing or decreasing. • The direction is the newest given data from this technology which allows for a clearer interpretation and prediction of future glucose levels.

8. Disadvantages of Continuous Glucose Monitoring • Safety- The implanted sensor is designed to be used, currently, for a short period of time. • Efficiency and Accuracy- Current day sensors do not always work properly for the first few hours after insertion because the bodies immune system tries to fight against the foreign object causing blood sugar reading to not be as accurate as desired. • Cost- Although more effective in predicting future levels of glucose, the out of pocket expense can be significantly higher because some insurance companies view this currently as experimental treatment.

9. Advantages of Continuous Glucose Monitoring • Frequency of testing = more data to work with • Viewing of trends allowing easier predictions and fine tuning of treatment. • Less frequent need for finger sticks • Less likelihood of complications because of uncontrolled diabetes.

10. Current Uses • The most common use for Continuous Glucose Monitoring is for fine tuning treatments for diabetics. • However, other studies are being done: • Military use- testing for a correlation between blood sugar levels and energy and endurance. • Diagnostics • Testing in pre-diabetic patients to see if there are any sort of trends throughout the day by showing sugar levels compared to food intake. • Also tests are being done by nutritionist to see if blood sugar levels can be to any use for eating habits in weight loss patients.

11. Reasons why this device is not more commonly used: • “The evolution of consumer electronics follows a predictable course. Initially, products are marketed to “early adopters” who are willing to deal with the unavoidable difficulties that arise from first- generation products. Wide adoption by a broader population of users requires achieving five goals: • 1. Improved Reliability • 2. Ease of Use • 3. Comfort • 4. Integration with other products • 5. Affordability”(Diabetes Technology & Therapeutic)

12. Future Possibilities • An Artificial Pancreas: a system that mimics, as closely as possible, the way a healthy pancreas detects changes in blood glucose levels and responds automatically to secrete the proper amount of insulin. • Although not a cure, an artificial pancreas has the potential to significantly improve diabetes care and management as well as to reduce the burden of monitoring and managing blood glucose.

13. Components of this Future • A Continuous Glucose Monitoring System • An Insulin delivery system • A computer program that “closes the loop” by adjusting insulin delivery based on changes in glucose levels. • If these three elements can be combined to work simultaneously, diabetics lives can be changed for a better future.

14. Work Cited • Brauker, Jim. “Continuous Glucose Sensing: Future Technology Developments.” Diabetes Technology & Therapeutics. 10.11 (2008). Print. • http://www.diabetes.niddk.nih.gov/dm/.../index.htm • http://www.minimed.com/products/.../cgm.html • http://www.diabetesmonitor.com/cgms.htm • http://www.webmd.com/continuous-glucose-monitoring • Blood glucose monitoring. (2010, March 1). In Wikipedia, The Free Encyclopedia. Retrieved 01:54, March 8, 2010, from http://en.wikipedia.org/w/index.php?title=Blood_glucose_monitoring&oldid=346992855