Managing Diabetes with Continuous Glucose Monitoring
Type 2 diabetes mellitus, also known as adult-onset diabetes, is a chronic condition characterized by the body’s impaired metabolic response to glucose. Normally, the body produces a hormone called insulin, which regulates the absorption of glucose into the cells. In type 2 diabetes, it is either insulin is not working properly or the patient is resistant to its effects. There is no known cure for adult-onset diabetes. It is usually managed through lifestyle modification. In some cases, oral diabetes medications and insulin therapy are prescribed when lifestyle changes are not enough. According to data by the American Diabetes Association, 1.5 million Americans are diagnosed with diabetes annually.
Current Available Treatments
As much as possible, type 2 diabetes is controlled with healthy diet, exercise, and blood sugar monitoring. Prescription medications are often the last resort for people with adult-onset diabetes as lifestyle modifications often suffice. People with type 2 diabetes have abnormally high blood sugar that can cause long-term complications like certain heart diseases. For diabetics, the goal is to always keep blood sugar within normal limits.
Switching to a healthy diet works wonders in patients with type 2 diabetes. As diabetics are generally incapable of properly processing sugar, the first piece of medical advice they get is to always find healthy alternatives and practice proper portion control. Fruits and vegetables, whole grains, lean protein, low-fat or fat-free dairy, and unsaturated fats are some of the components of a well-balanced diet. They fuel the body in many different respects other than stocking it up with glucose. As much as possible, saturated fats, sugar, and salt must be limited or altogether avoided.
Exercise is the best way to lower blood sugar in diabetics. The surplus of blood sugar is alleviated by the muscles’ ability to utilize glucose without the aid of insulin. When a patient with type 2 diabetes exercises, his muscles get whatever glucose is available as fuel, and therefore reduces its amount in the bloodstream. In addition, a patient’s resistance to insulin is lowered with regular exercise, enabling the cells to use it more effectively.
When lifestyle modifications fail, oral diabetes medications and insulin injections are often prescribed to patients to assist in lowering blood sugar. First-generation diabetes pills contain insulin secretagogues; these are chemicals that cause the pancreas to produce more insulin. However, they do not completely resolve the body’s inability to process insulin. They only increase the amount of insulin in the bloodstream so that there is more to process. Second-generation diabetes pills also do the same but more effectively. In time, the pancreas ceases insulin production entirely, rendering insulin secretagogues useless. This is when insulin shots assume the mantle. Taking diabetes medications works hand-in-hand with consistent blood sugar monitoring as blood sugar levels dictate the patient’s course of action and medical decision-making.
Continuous Glucose Monitoring (CGM)
Living with diabetes can be very inconvenient when it comes to checking and monitoring blood sugar levels. Pricking a finger and running it through a portable blood glucose meter may be one of the breakthroughs in getting ahead of diabetes, but it takes up too much time and effort. Moreover, it only provides a one-time picture of a diabetes patient’s blood sugar that is not even archived for reference. In order to be always one step ahead of diabetes, a patient should be well-informed of his blood sugar levels at all times. Thanks to recent advancements in medical technology, this is now possible.
Continuous Glucose Monitoring (CGM) is the future of diabetes management. It is achieved through a small device embedded in the skin that transmits blood glucose levels to a receiver or a compatible smart device wirelessly for up to seven days. The blood glucose measurement and data transmission happen every five minutes throughout the day, providing the patient with a fully recorded trend of his blood sugar levels. The CGM can also be calibrated according to the patient’s baseline levels. With every update sent, the patient is reminded of not only his current blood sugar level but also of whether it is going down, going up, or remaining within normal limits. The best part is that it completely eliminates the need for a confirmatory finger prick. However, as the technology is new and relies heavily on automation, careful calibration is required to ensure the accuracy of data. In this case, the old glucose meter is still needed.
The Future of Diabetes Management
The executive director of the Jaeb Center for Health Research in Tampa, Florida, Roy W. Beck, MD, PhD, together with his colleagues, published a study that revealed CGM to be beneficial to type 2 diabetes patients who have multiple daily insulin shots. The trial involved a total of 158 type 2 diabetes patients that use several insulin injections daily, 50% of whom showed significant HbA1c improvement in 24 weeks with CGM. The criteria for eligibility are at least 25 years of age, medicating with multiple insulin shots daily for at least a year, and HbA1c of 7.5% to 10.0%. On average, the subjects are aged 60 and have been living with diabetes for 17 years. During the first 12 weeks, a significant drop in HbA1c had been observed from baseline 8.5% to 7.5% in the CGM group and 7.9% in the control group. By week 24, the CGM group was at 7.7% and the control group at 8.0%. The authors of the study found this improvement significant as it was achieved without pharmacologic alterations.
While the study is said to be “well executed” according to Vanessa Arguello, MD and Matthew Freeby, MD of the David Geffen School of Medicine at the University of California in Los Angeles, there are still a few issues to be addressed with continuous glucose monitoring such as proper education on its use, cost, and limited insurance coverage. As CGM is a new approach to managing diabetes, it still requires further study to be fully understood and utilized effectively.
Conclusion
Diabetes is not an easy condition to live with. It requires a lot of effort on the part of the patient to keep it at bay. While a healthy diet and regular exercise are guaranteed to control blood sugar levels, a patient with type 2 diabetes still needs to be sure of how much sugar is in his blood at the moment to make important medical decisions. Continuous glucose monitoring (CGM) is a promising technological advancement in medicine that allows a diabetic to be fully aware of his current blood sugar levels and presents them in a way that shows trends. This feature of CGM is instrumental in making life easier for patients living with diabetes as it basically acts like a real-time reminder that provides up-to-the-minute calls to action. While a recent study has revealed the significant positive effects of CGM use to type 2 diabetes patients, further studies are still needed to spot and resolve possible challenges, one of which is the need for daily calibration that involves the use of the old blood sugar meter. In addition, insurance coverage for continuous glucose monitoring is limited at the moment, and because it is a new approach to diabetes management, proper patient education is vital in ensuring its proper use and maximization.
