Find out how new diabetes technology called continuous glucose monitoring could make finger pricks a thing of the past.
By Chris Iliades, MD
Medically reviewed by Pat F. Bass III, MD, MPH
Constant finger pricks with needles is a task that most people with diabetes accept as part of life. Blood tests check blood sugar or glucose, and
regular glucose monitor measurements are essential for making decisions about food, exercise, and medications. In the near future, however, needle-free blood sugar testing may replace the finger prick through a technology called continuous glucose monitoring (CGM).
Diabetes and Blood and Sugar Monitoring
How? Needle-free blood sugar testing devices replace the finger prick part of blood sugar testing with a tiny sensor that is implanted under the skin. The sensor measures glucose levels in the fluid beneath the skin, which corresponds closely to blood sugar levels. Instead of a needle prick several times a day, the CGM system sensor stays in place for several days.
"A transmitter continually picks up readings from the sensor and sends them to a monitor that will set off an alarm if blood sugar is too high or too low," says Howard Wolpert, MD, who established and directs the Insulin Pump & Continuous Glucose Monitoring Programs at the Joslin Diabetes Center in Boston. Dr. Wolpert is also the lead researcher on several CGM studies.
CGM Diabetes Technology
"What we have now is just the first generation of
continuous blood sugar testing technology," says Wolpert, who notes that needle-free blood sugar testing is not widely available yet. "In the future we will have systems that are more accurate and easier to use," he says.
The sensor and transmitter are water-resistant, so patients can bathe or shower with them in place. The glucose information is sent by radio waves to a monitor sized to be handheld. The Joslin CGM program has already trained more than 570 adults with type 1 diabetes to use CGM.
CGM systems that are now available and approved by the U.S. Food and Drug Administration (FDA) include devices made by Abbott, DexCom, and Medtronic. A new system that replaces the implanted sensor with a sensor that works through the skin surface, called Symphony tCGM (made by Echo Therapeutics), is working its way through FDA approval.
In recent clinical studies at Thomas Jefferson University Hospital in Philadelphia, the Symphony tCGM system was able to give clinically accurate blood sugar readings 98.9 percent of the time in surgery patients.
The Pros and Cons of Needle-Free Blood Sugar Testing
Current CGM systems offer some big improvements in diabetic technology:
- A continuous display of glucose levels is available for five to seven days before the sensor needs to be changed.
- The information can be downloaded to a personal computer. Long-term trends appear in graph form and can be correlated with diet and activity.
- Readings on the handheld receiver can be programmed to appear every few minutes.
- An alarm system warns of high or low blood sugar levels.
"We still have a ways to go before CGM replaces the traditional finger stick," Wolpert notes. "The systems still need to be refined. They are not as accurate as they need to be." Drawbacks include:
- CGM measures glucose in fluid beneath the skin and is still not as accurate as actual blood sugar testing.
- Before an insulin dose can be changed, a CGM reading should still be verified by a blood sugar reading.
- Learning how to use the system can be challenging for some people.
- The system is expensive and may not be covered by insurance.
Researchers are also working on combining CGM systems with a computer that will respond to continuous glucose readings and trigger an insulin pump that will automatically dispense the right amount of insulin. This diabetes technology is called an artificial pancreas. "We are still several years away from replacing the finger prick and the glucose monitor, but diabetes research is moving forward all the time," says Wolpert.
For anyone with diabetes, diabetes technology could change the way you test your blood sugar in the not-too-distant future. In the meantime, using a finger prick and a glucose meter is still the best way to keep your diabetes under control and prevent complications.
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