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Continuous Monitoring of Blood Glucose in Diabetes Control
As of now, there are about three Continuous monitoring glucose systems available that do provide great round figures of your blood glucose. There is the Meditronic Guardian REAL-Time System, which you can use by itself, the DexCom Seven, that can also be used alone or integrated into a Minimed pump, and lastly, the Freestyle Navigator. The only one approved for children is the Meditronic Guardian System. These three systems all use a sensor which is metallic, inserted just below the skin. The sensor tracks glucose in the fluid between the cells in fatty tissue under the skin. The sensor is very thin. Devices that are loaded by springs make sensor insertion painless and quick. The sensor records information which is carried by radio signal into a receiver or monitor. This displays a guesstimate of the current blood sugar levels. The life of the sensors used should last between 3 up to 14 days. Both the Meditronic and DexCom receiver monitors will provide you with updates on blood sugar readings about every 5 minutes. These monitors will also sound an alarm if the blood sugar goes way too high or too low. Fingersticks are still important to compare readings from CGM monitoring to regular monitoring.This ensures that the CGM monitoring is accurate. New sensors just inserted to the skin take a little time to adjust. It is often a 12-24 hour period before they become as accurate as they should. Fingersticks are more accurate at this time then, for a comparison sake. And since Continuous monitoring systems measure the glucose level of interstitial fluids, there is a 5-10 minute delay between the regular blood sugar meter, and the reading you are getting with CGM. For instance, the CGM monitor will probably be lower than a fingerstick done at the same time. And if the blood sugar is rapidly falling, the CGM monitor will be much higher. The continual monitoring numbers then, should only be used for insulin dosing in the cases of the following:
Your regular blood sugar monitor matches the CGM values within 10%. Your blood sugars are not becoming at a hypoglycemic or hyperglycemic level.
Your sensor has not received any kind of data gaps, or error display messages.
The Meditronic device displays short-term trends within the past 20 minutes, whereas the Dexcom Seven system displays a 1 hour trend graph that has about the same information on it. The Dexcom and Meditronic systems display three hour trend graphs. Longterm trends are displayed on a 9 hours graph with the DexCom system, and the 12 hour trends on the Guardian system. The only 24 hour trend showing glucose levels is used with the Guardian integrated pump. The best source of this type of continual monitoring is the alarm systems that will let a person know when they are too high or low. You can set your high and low target ranges on these meters, and they will give a signal if your blood glucose is off-kilter either way. All in all, wearing a monitor which is continuous is best for someone who has more critical rises and falls as I mentioned in the first part of my article. The video below gives quick details on continuous monitoring.
These systems are great for brittle diabetics that are hard to control, and allows them to lead more productive, normal lives.
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