There is a wealth of information about your health circulating in your blood. For people with diabetes, accessing that information can be a matter of life or death.
For nearly 30 years, the prevailing technology for checking the blood sugars of someone with diabetes has been the fingerstick. People with diabetes are often asked to stick their fingers and check their blood multiple times a day to assess whether their blood sugar levels are too high or too low. If their blood sugar, or glucose levels, are too high at a given point, they might need to take medication. If the levels are too low, they might benefit from eating something.
Because glucose levels fluctuate constantly, some patients require checking their blood sugar levels six to eight times a day. While the fingerstick has been keeping people alive, preventing organ failure and vision damage, it is a major pain point (pun intended) for people with diabetes.
Even as an endocrinologist, I have to admit it is imperfect, uncomfortable and inconvenient. That is why I get excited to share advances in glucose monitoring technology with patients. Continuous glucose monitoring (CGM) devices are now on the market that are changing the paradigm of diabetes management.
There are two products approved on the market today, and likely more in the works. These CGM products differ slightly from one another in methodology and price, but what they have in common is the ability to eliminate (or, in some cases, nearly eliminate) the need for a patient to stick his or her finger.
Dexcom G6 and the FreeStyle Libre are two products that provide continuous monitoring of glucose levels through tiny filaments that penetrate the skin. These devices use interstitial fluid, or the natural fluid in your tissue, to assess the glucose levels in your blood.
There are rarely “happy” surprises that I can share with patients, so I really enjoy telling patients that staying on top of their health just got easier.
In fact, these devices have improved diabetes management for doctors as well. By continuously monitoring glucose levels, these devices provide the equivalent of up to 300 fingersticks’ worth of information a day. I liken it to reliving an event through video rather than through photographs. The amount of information provided by this new technology renders the older technology incomplete.
For many people, CGM has made all the difference. One of my patients, for example, followed all the rules, diligently sticking his finger at mealtimes to check his levels. Even so, one of his blood scores would consistently read abnormally high, and we couldn’t figure out why. By continuously monitoring his glucose, we were able to discover that well after his meals his blood sugar levels spiked. This was an unexpected finding, and one that allowed us to switch up his medicine and regulate his levels.
He feels better physically, and he feels reassured knowing he can better monitor his health. I have noticed this feeling of empowerment with a lot of my patients, and I suspect this new technology could even act as a behavior modification tool. When you see your sugars go down because you’ve exercised or spike because you ate lunch at the drive-thru, you are given this impossible-to-ignore mechanism to enforce good habits.
Time will tell if I’m right. But by eliminating the fingerstick, this new technology is making diabetes management easier, more detailed and less painful. It’s a lifestyle change that’s easy to stick with.
David Ahn is an endocrinologist and program director, Mary & Dick Allen Diabetes Centers, Hoag Hospital, Newport Beach, CA.
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