Tech Talk with Kellie Rodriguez, MSN, CDE, CPT
There have been a few great advances in technology recently. Below, the Diabetes Research Institute's Kellie Rodriguez, MSN, CDE, CPT, breaks down the latest on new diabetes tools.
Blood Glucose Meters
>> New features include backlight, data storage and more!
Blood glucose meters are becoming more discreet and many have the ability to simply check the glucose value and if desired, capture important event information to help make sense of the glucose reading (eg – exercise, carb intake, stress, illness medication, etc.).
Most meters are user-friendly, and there has been progress in making the lancet (finger-pricking device) smaller and as pain free as possible. Three of the latest meter additions to the US market:
• Contour USB meter has become especially popular for its features, including color display, easy trend tracking and plug-and-play USB system. The integrated Glucofacts Deluxe software enables easy input and analysis of data for trend recognition. Reports can then be sent via email, direct plug-in and/or to office computers.
• OneTouch Verio IQ meter is the first US available meter that has ‘Pattern Alert,’ with the ability to automatically alert you to blood glucose patterns that might be occurring, notifying patients when they’re trending high or low. The meter also comes with a written reference tool, called the ‘Pattern Guide,’ to assist in identifying possible strategies for various high or low blood glucose patterns that are occurring.
• iBGStar meter is without doubt the smallest currently-available meter in the US that is compatible with the iPod touch and iPhone. The meter can be used on its own or connected directly to an Apple iPhone® or iPod touch® to easily display, manage and communicate your diabetes information. The iBGStar Diabetes Manager app allows you to input your data with personalized notes and can then be emailed or shown to your healthcare team for visits or management recommendations.
Continuous Glucose Monitors
>> Do you want a snapshot or a video replay?
While traditional glucose monitors provide a photo of the glucose value, a continuous glucose monitor (CGM) provides a DVD-version. When you monitor your blood glucose 4-6 times a day with the traditional system, assumptions must be made about what is happening in between the available results. CGM has the ability to provide 288 glucose values over a 24 hour period – providing invaluable trending information – especially in the overnight period and following a meal.
Because CGMs measure the glucose in the interstitial fluid (fluid between cells), there is a lag time between blood glucose readings and the CGM reading – therefore, there can be a large discrepancy if the glucose is rising or falling quickly. Even if you’re using a CGM, you still need to use a traditional meter/fingerstick to make medication decisions. There are 4 CGM systems available on the market in the US:
• DexCom 7 Plus – 7-day system
• Paradigm / Revel Insulin Pump / Sensor combination (Medtronic) – 3-day system
• Guardian (Medtronic) – 3-day system
• I-Pro (Blinded glucose system used by physicians in clinical decision making – glucose data is only seen after the system is downloaded) – 3-day system
-- Combination of continuous glucose monitors and pumps -- two-in-one packages
• Paradigm / Revel Insulin Pump / Sensor combination (Medtronic)- 3-day system
Future pump designs are trying to incorporate tubeless systems (patch pumps) with glucose detection capabilities, with the ability to respond to glucose changes independent of the patient using them – called a closed loop system.
Medtronic recently launched mySentry – a remote glucose monitor. The mySentry system consists of a Monitor with a color screen, a power supply, and an Outpost that transmits information from your Medtronic MiniMed Paradigm® REAL-Time Revel™ System to the mySentry Monitor, up to 50 feet away or greater.
This tool has specific benefits for parents with children with type 1 diabetes wanting to monitor their child’s blood glucose levels, especially in the overnight period. The mySentry system is based on the principles of a remote baby monitor, but instead of listening out for a baby crying, you have the ability to listen out to glucose readings.