Continuous Glucose Monitoring: a Better Way for Type I Diabetes Patients

With the deadly risks threatening type 1 diabetic patients occasional monitoring of blood sugar levels is not enough to keep them safe, says a new report.  Continuous glucose monitoring is the best way to ensure proper medication and avoid dangerous complications and daily hazards like hypoglycemia.

Type 1 diabetes is different from type 2 and potentially more serious.  The type 1 diabetic is usually a young person, a child or even a baby whose immune system has attacked the beta cells in the pancreas that manufacture insulin.  Scientists do not understand why this happens, but type 1 diabetes is common, making up about 10% of all diabetes cases in the US.

A type 1 diabetic will need glucose testing and have to take insulin all his life, as his body produces none.  Glucose testing is commonly done with finger sticks or fingerpicks, using a device with a sharp point for a jab that draws a few drops of blood. This is painful and distressing for a young child, but the sufferer soon becomes used to the procedure being performed.  One of the things finger stick testing is used for is the glycated hemoglobin test, or HbA1c, which tests how well the diabetic is controlling his blood sugar levels.

The monitoring of blood glucose in this way is vital to the continued wellbeing of the patient, as the doctor is able to keep an eye on his blood sugar control and advise if his blood sugar level is not maintained well.  Poor control of blood sugar in diabetics is associated with increased risk of stroke, heart disease, kidney failure, blindness, and gangrene leading to amputations.  And poor control of blood sugar can also lead to low blood sugar levels, which can result in queasiness, dizziness, disorientation and even diabetic coma.  Diabetics suffering from low blood sugar may become so confused that they wander away or do strange things they would not do in normal circumstances.

Nevertheless, the finger stick tests only show a “snapshot” of blood sugar levels, which could rise, or fall at other times, say the researchers.  The new guidelines published by Dr David Klonoff and his team at Mills-Peninsula Health Services, San Mateo, California, suggest continuous glucose monitoring (CGM) should be the method for type 1 diabetics.  A range of CGM devices is available, with sensors inserted into the body tissues and testing interstitial fluids.  Because the monitor is used 24 hours a day the blood sugar level is constantly watched, and so there is much less chance of it plummeting to hypoglycemia or rising to levels where damage is inflicted on organs.

Dr Klonoff and his colleagues say the CGM should be used for children over eight and adults with type 1 diabetes, although the systems are costly and the devices have been criticized as not being very accurate because they test body fluids instead of blood.  The team also suggested that those who cannot use CGM all the time could use it intermittently to monitor overnight blood sugar levels and levels after meals, both times when blood sugar can change by falling or rising drastically.

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