This is the age of technology and if there ever a time to have a condition that needed technology then this is the era. Even only 15 years ago things have advanced so much in technology where blood sugar levels are concerned that it is unrecognisable compared to back then.
There are lots on the market and this is just a guide to a few pieces of technology that we have in the UK and we are only scratching the surface.
There are many different blood glucose (BG) meters on the market. Everyone loves their own meter and if they don’t they can change to a new one and ask their GP to change the repeat prescription to the new test strips. Normally the easiest way to do that is ring the company of the meter you want and ask for one. Any decent company will send you a new meter free of charge as they make their money on the test strips and needles.
Accuracy of meters :
At the moment BG meters have to meet the following accuracy standards from 2003 which state that 95% of blood glucose results should be:
Within ± 0.83 mmol/L of laboratory results at concentrations of under 4.2 mmol/L
Within ± 20% of laboratory results at concentrations of 4.2 mmol/L (75 mg/dL) or more
However in 2013 new much tighter accuracy standards were agreed, requiring that 95% of blood glucose results should reach the following standards and that all companies who manufacture blood glucose meters must ensure that their meters meet this new 2013 accuracy standards by the end of 2016 :
Within ± 0.83 mmol/L of laboratory results at concentrations of under 5.6 mmol/L
Within ± 20% of laboratory results at concentrations of 5.6 mmol/L (100 mg/dL) or more
This is a good article to look at regarding meters and accuracy;
Blood Glucose Test Strip (BGTS) evaluation protocol and results May 2015 by NHS Greater Manchester Medicines Management Group: Read Article
This is also a good write up regarding accuracy and also has a list of meters which conform to the above accuracies: Read Article
A lot of these meters boast to have within 10 or 15% accuracy, worth doing your homework and some tests yourself between meters if you can.
Continuous Glucose Monitoring (CGM)
Stand alone devices :
These are devices that measure the interstitial fluid below the skin. There is approximately a 15 minute delay of reading behind capillary blood ie finger/toe etc. However this technology is quite ground breaking but getting funding for these is quite hard in the UK even for children although it can be done, it’s a bit of a post code lottery.
The following machines are true CGM’s. They can all be privately funded as well as NHS funded (in some cases). The are expensive but worth every penny. They are manually inserted into the skin, sub cutaneously, they are very easy to insert, all have insertion devices but some people choose to insert by hand. They all basically do the same thing: They test the fluid roughly every 5 minutes and wirelessly transmits the readings to a handheld monitor which are very small and light.
Some people find using one of these helps with tighter control (especially if insulin dependent). They have trend arrows, alarms and alerts informing the user they are dropping or rising at a certain rate or have reached a hypo level. The sensors for all these are licensed for around 6 or 7 days usage although with a bit of tricking and tweaking more days can sometimes be achieved from them which is self funding is an added bonus. It is very much an individual preference which machine you opt for, the sensors seem to choose the person so if a trial can be arranged then this is a good idea.
Dexcom G4 : Click here
Medtronic’s Guardian Realtime : Click here
Abbott’s Freestyle Navigator : Click here
Abbott’s Libre described as the Flash Glucose Monitoring System is the latest gadget on the market and is a much more affordable alternative. It does not have the alarms and alerts but it does measure the same interstitial fluid and you just scan the button sized sensor and it uploads all the readings since the last scan. More and more insulin dependent people, including children and teens are using the Libre for its convenience and affordability. Click Here
Insulin pumps with integrated CGM
Medtronic : their latest pump to reach the public in the UK, Australia and Europe is the 640G system which combines insulin pump therapy with an integrated CGM system using their own enlite 2 sensors. Amongst other things including trend arrows for hypos and hypers, it features Smartguard, (great explanation of smartguard : Click here) the suspend before low, which, after a couple of criteria are met, switches off insulin for a certain period and when it then reaches further criteria will switch insulin delivery back on. It boasts it will head off around 80% of hypoglycaemic episodes. More about the 640G system
Animas : the Vibe is Animas’ integrated insulin pump and continuous glucose monitoring system which uses the Dexcom sensors. If using the sensors this pump will spot downward and upward trends and alert the wearer of impending hypos and hypers. More about the Animas® Vibe® Insulin Pump & Dexcom G4® PLATINUM CGM System
Insulin pumps without CGM
Accu-Chek : their newest pump is the Insight. This has a stand alone meter that you use as a glucomter to test your blood sugar level and also as the means to give a bolus or change settings on the pump itself. It bluetooths the information to the pump so you do not need to use the pump itself. More about Accu-Chek