A Diabetes Technology Revolution
Nov 17, 2017, 08:00 AM
WOW! What a great time to be involved in diabetes. Although it would definitely be better for all if we could just cure the disease, never in history have people with diabetes had more options for medications and technologies to help them manage their condition.
If you have not been keeping up with the news, several impressive diabetes technologies were recently released.
Closed loop insulin delivery system
I am sure many CDEs have encountered patients with diabetes who have hypoglycemic unawareness or nocturnal hypoglycemia. This can be very challenging and dangerous for our patients. To assist with this challenge, the FDA recently approved a closed loop insulin delivery system. This new system consists of an insulin pump, a sensor and a blood glucose monitor to track blood sugar levels. The sensor communicates with the pump, allowing it to adjust insulin administration based on glucose patterns. The pump/sensor combo has to be calibrated two times a day with a separate blood glucose monitor. With proper calibration, the sensor keeps track of blood glucose values 24-hours a day.
Utilizing this glucose information, the pump changes or even “suspends” insulin delivery if the glucose level falls below a pre-set target. It also alerts the wearer to drops in glucose, allowing the wearer to verify the glucose value with a finger stick and to consume a snack to correct the low glucose if needed. This feature can significantly decrease hypoglycemic events, especially during the night. The pump alerts the wearer to rapid rises in glucose while it modifies the insulin rate to correct the elevated glucoses. I have several friends and colleagues who wear this new pump and they are impressed with the newfound stability of their glucoses. They essentially eliminated hypoglycemic events and have had many fewer glucose excursions. Find more information here.
I am looking forward to working with these new weapons in our fight to improve our patients with diabetes lifestyle and health outcomes.
A continuous glucose monitor that doesn't need calibration
The FDA also recently approved the first continuous glucose monitor (CGM) that does not require finger sticks to calibrate the sensor. A sensor about the size of a silver dollar is attached to the upper arm. A very small plastic needle or catheter obtains interstitial fluid. The wearer uses a reading device to get the information by waving it over the sensor. Some may argue that this system is not really a continuous glucose monitor, as you only get a glucose value when you wave the reader over the sensor. The advantage to this system is that the wearer does not have to do the daily calibration required by other CGM systems. The FDA also approved using glucose results from the sensor to make treatment decisions without verifying the glucose value with a finger stick glucose monitor. However, this sensor does not provide alarms or alerts for out of target glucose values, but there are significant potential cost savings from not having to use six to eight glucose strips per day. Learn more from the FDA.
Super-fast-acting insulin
A new super-fast-acting insulin will be available shortly. It has a faster onset and peak for those with diabetes who might benefit from such a feature.
I am looking forward to working with these new weapons in our fight to improve our patients with diabetes lifestyle and health outcomes.
About the Author
Barbara Walz is an RN, BSN and has been a certified diabetes educator since 1986. Since 2000, Barbara has coordinated a multi-site diabetes study examining the macro-vascular effects of diabetes at the South Texas Veterans’ Healthcare System under the supervision of Dr. Ralph DeFronzo.