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MedTech Outlook | Thursday, August 12, 2021
Continuous glucose monitoring is a wearable device that enables patients to more easily check their blood sugar levels over time.
FREMONT, CA: Over the last two decades, the care of Type 1 diabetes mellitus (T1DM) has shifted from self-monitoring of finger stick capillary blood glucose to continuous glucose monitoring (CGM) and from multiple daily insulin injections (MDI) to continuous subcutaneous insulin infusion (CSII, colloquially known as "insulin pumps").
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How CGMs function
CGMs were introduced in 1999 with the clinical goal of increasing patients' self-awareness of their real-time glycemic control and lowering the cumulative burden of diabetes treatment. These monitors measure the glucose concentration in interstitial fluid and convert it to the predicted glucose concentration in the blood via algorithms.
These devices calculate capillary blood sugar every five minutes and transmit it in real-time via short-range wireless communication to a receiver, mobile device, or insulin pump. Each day, the data is given as 288 separate data points.
The analytics supplied by the data stream enables both the patient and physician to visualize blood sugar patterns and changes in real-time or retrospectively.
The ability to pinpoint precise time points associated with glucose perturbations and nutritional shortages may help to explain times of poor glucose control and facilitate the development of more effective management measures. Drilling down to this level enables the physician to change insulin doses in accordance with the patient's physiology, diurnal cycle, time of day, and specific meals.
Additionally, imminent hypo- or hyperglycemia can activate an audio alert, allowing for preventive self-treatment with oral glucose or insulin if indicated.
The clinical utility of CGM
While the evidence is equivocal, many trials have demonstrated that CGM use improves outcomes in pregnant and non-pregnant patients receiving CSII or MDI insulin.
Clinical gains associated with CGM use include decreased hemoglobin A1c levels, greater time spent within target glucose objectives, and reduced hypoglycemia incident frequency.
Additionally, some findings suggest that CGM may assist people with type 2 diabetes. CGM is remarkably indicated for pregnant women with type 1 diabetes. Several studies have discovered lowered incidences of preeclampsia, an increase in hemoglobin A1c, and a decrease in fetal macrosomia. There have been no adverse events associated with the use of CGMs, and there have never been any side effects or adverse events related to the use of CGMs during or outside of pregnancy.
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