Continuous Monitoring Technology Helps People Manage their Diabetes
Diabetes is a lifelong disease affecting nearly 26 million Americans-more than 8 percent of our population. Of these, 19 million children and adults have been diagnosed with diabetes, while an estimated 7 million are not yet aware that they have it. In 2010 alone, 1.9 million adults in the U.S. were newly diagnosed with either type 1 or type 2 diabetes.
When someone has diabetes, they have high levels of sugar, called glucose, in their blood. Glucose is a source of energy for the body. People with diabetes have abnormal levels of blood sugar because their body is unable to move the glucose from the bloodstream into the muscles, fat and liver, where it can be used as fuel. In a normally functioning body, the pancreas makes insulin, which moves the glucose for storage. With diabetes, the pancreas doesn't make enough insulin and/or the body's cells don't respond normally to insulin.
Type 1 diabetes, in which the body makes little or no insulin, is most often diagnosed in children. Type 2 diabetes, which represents the greatest number of diabetes cases, occurs most often in older adults, but young adults and even children are now being diagnosed more often. There is no cure for diabetes.
The purpose of diabetes treatment is to manage a person's glucose levels, while preventing symptoms and other problems from developing. When the blood sugar is poorly controlled, with levels swinging from high to low, there is a higher risk that disease of the kidneys, eyes or nervous system may develop, or that a heart attack or stroke may occur.
"Today there is a technology that can help us get a better overall picture of a person's blood glucose level," said Prasad Katta, M.D., an endocrinologist with Washington Township Medical Foundation who is also on the medical staff at Washington Hospital. "The Continuous Glucose Monitor measures glucose levels over a period of time. This gives us a better view of the pattern of their glucose level, rather than a snapshot in time, which is what we get from the finger-stick blood test."
Data gathered by continuous glucose monitoring is also a valuable addition to the results of the commonly used A1C test, which measures a person's average blood glucose level over three months.
The Continuous Glucose Monitor, measuring slightly larger than a quarter, is attached to a small tube inserted under the skin, usually in the stomach area. The device measures the level of the person's "interstitial" glucose, which correlates well with blood glucose levels. Readings are automatically taken every five minutes, 24 hours a day, and the data is checked and stored in the monitor.
"My patients usually wear the monitor for three or four days," reported Dr. Katta. "Then, they bring it into our office so the information can be downloaded and analyzed. While the patient wears the monitor, they must also continue to do regular finger-stick blood tests to check their glucose level throughout the day. All of this information, along with a record of what and when they eat, gives us a fuller picture and helps us make better decisions about the insulin regimen the patient should follow to help achieve the best possible management of their diabetes."
According to Dr. Katta, the Continuous Glucose Monitor is an excellent tool for patients who are taking multiple insulin injections throughout the day, who use a pump to deliver their insulin, or who aren't checking their sugars often enough. In addition, it can be helpful for people who are having a lot of unexplained highs and lows in their glucose level.
"In my practice, about 50 to 60 patients have their own monitors and bring them to my office each time they come in, so the data can be downloaded," added Dr. Katta. "Most use the monitor in combination with an insulin pump."
People who use an insulin pump control the timing and amount of insulin they take by programming the necessary information into the pump. A background amount of insulin is administered to keep a person's glucose levels normal when they are not eating. Then, an additional dose of insulin can be given on demand, if needed when they eat a meal.
The Continuous Glucose Monitor communicates with the insulin pump. If the blood glucose level is abnormal after eating, a warning alarm goes off, alerting the person to adjust the amount of insulin they need.
People who take three to four insulin injections per day instead of the pump can also benefit from the monitor. It gives them an overall picture of their glucose levels over a four-day period. Once the data is downloaded in the doctor's office, they can work with their doctor to develop the best overall plan for taking insulin, checking glucose levels and eating meals.
"With my patients who don't have the insulin pump, we use the Continuous Glucose Monitor two or three times a year," stated Dr. Katta. "It helps us to manage their glucose better, especially if they are experiencing highs and lows or taking multiple daily injections."
For more information about diabetes and continuous glucose monitoring, go online to, www.diabetes.org, the Web site of the American Diabetes Association. To find a physician with Washington Township Medical Foundation, go to www.mywtmf.com.